How to Support Recovery         and     Not Addiction   Dawn Farm Education Series            May 15, 2012Charles F. Gehrk...
For the next 75- 90 minutes:          1. Remember the title of the presentation          is: “Support Recovery” - not crea...
Objectives Learn what we do that supports addiction. Learn how we have to change. Learn what we can do to support recov...
Definitions Addiction - is a primary, chronic, progressive,  relapsing disease which may be (often is) fatal. Recovery -...
Progression of Addiction and Codependency                                         Addict               Early              ...
5/11/12   6
Family Recovery                            Blues                                                                          ...
Support Addiction                Support Recovery Lack of knowledge                                 Education about addi...
Education: Believing the behaviors we see area choice supports the disease.             “I wish he would…….”            ...
Education: Understanding addiction is adisease supports recovery.                         Definition of disease          ...
Defined set of          Predictable course &     Si’s/Sx’s                outcome   Craving   Loss of control   Compuls...
Education: Addiction is a disease Why?        (con’t)     *Cause may or may not be known.       Currently our understandin...
Education: responding to the behaviors and not the disease supports the disease. Everyone/everything revolves around the ...
Education: responding to behaviors and    not the disease supports the disease. Anger: (often results from: fear, guilt, ...
Education: responding to behaviors and not the disease supports the disease. Perfectionism: unable to control the addict ...
Education: Enabling supports the disease.5/11/12                                 16
Education: definition of enabling:                        Anything we do or do                         not do that gets  ...
Education: Enabling - why do we do it? Believe using is a choice. (remember the part of the                              ...
Education: Enabling behaviors5/11/12                         19
Education: Don’t enable - detach which    supports recovery.       Definition: is to separate ourselves emotionally      ...
Education: Don’t enable - detach to support  recovery.     (con’t) Practical applications of detachment:       do not do ...
Education: We will take care of it   ourselves supports the disease.   Common misconception: problems in the addict’s    ...
Education: Get help/assistance which supportsrecovery and responds to the disease.5/11/12                                 ...
Education: Get help/assistance which supportsrecovery and responds to the disease. First Step: Ask “Is what I/we are doin...
Education: Get help/assistance which supportsrecovery and responds to the disease.     How/where do I/we get help/assista...
Conclusions           Remember:           1. You didn’t cause it, can’t control it, and can’t              cure it.     ...
9. And most important of all:Remember: “Addicts and alcoholicsare not bad people trying to be goodbut sick people trying t...
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How To Support Recovery and Not Support Addiction - May 2012

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"How to Support Recovery and Not Support Addiction" was presented on Tuesday May 15, 2012, by Dr. Charles F. Gehrke, MD, FACP, FASAM. When all else has failed - what does work when confronted with a loved one’s addiction? What does not work? What can others do to help? What does not help? What role does an individual play in supporting another person’s recovery process? These and other questions will be addressed in order to assist participants to find effective methods to successfully support another person’s recovery, avoid enabling another person’s addiction, and maintain their own health and well-being. This program is part of the FREE, annual Dawn Farm Education Series. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please contact Matt Statman, LLMSW, CADC, Education Series Coordinator, at 734-485-8725 or info@dawnfarm.org, or see http://www.dawnfarm.org/programs/education-series.

Published in: Health & Medicine

How To Support Recovery and Not Support Addiction - May 2012

  1. 1. How to Support Recovery and Not Addiction Dawn Farm Education Series May 15, 2012Charles F. Gehrke MD, FACP, FASAM
  2. 2. For the next 75- 90 minutes: 1. Remember the title of the presentation is: “Support Recovery” - not create or cause it. 2. Put aside any preconceived notions and ideas about addiction and recovery. 3. Put aside your rational thinking for a short time.5/11/12 2
  3. 3. Objectives Learn what we do that supports addiction. Learn how we have to change. Learn what we can do to support recovery.5/11/12 3
  4. 4. Definitions Addiction - is a primary, chronic, progressive, relapsing disease which may be (often is) fatal. Recovery - is a process of overcoming both physical and psychological dependence on a psychoactive drug and is a commitment to abstinence based sobriety. (ASAM Textbook of Addiction Medicine ,4th edition) Disease - is a state of ill health characterized by the abnormal function of one or more organs, a definable set of signs and symptoms, a predictable course and outcome with or without a known cause.5/11/12 4
  5. 5. Progression of Addiction and Codependency Addict Early Middle Late no detectable effects beginning to have uses to prevent impact on daily life withdrawal without treatment consequences increase _____________________________________________________________ Codependent’s Progression no visible effects beginning to feel responsible feels compelled to help for the addict - feels compelled feels scared, insecure to help - feelings of guilt overwhelmed, desperate5/11/12 5
  6. 6. 5/11/12 6
  7. 7. Family Recovery Blues Joy Intolerance Suspicion Courage Problems multiply Love Worry Makes amends Irritability Seeps help Peace of mind Arguments Avoiding reference Service At ease with life Distrust Extravagance New friends Return of respect Self-defense W Unhappiness Spiritual examination Appreciates spiritual values Depression IT Religious needs Return of confidence Irrational behavior Release HO LP Denial (fantasy) New interests developThreats made but not fulfilled Self-neglect Trust, openness Guilt is gone HE UT Takes responsibility Alibi Honesty Return of self-esteem Loss of interest Dishonesty Diminishing fears H HE Infidelity IT Imaginary illnesses Daily living pattern improves Isolation LP Façade W Develops optimism Uses prescribed drugs Blames others Begins to relax Loss of self respect Escape Cover-up ceases Remorse Jealousy Becomes willing to change Social withdrawal Shares with others Patent medicine use Need to control lessens Indefinable fears Recognition of role Drug abuser Seeks help Bankruptcy of alibis Acceptance Admits defeat BOTTOM Recognizes disease Chronic depression Sincere desire for help Suicide attempts Prepared by 5/11/12 7
  8. 8. Support Addiction Support Recovery Lack of knowledge  Education about addiction about addiction *Using is a choice *Addiction is a disease *Responding to the *Responding to the disease behaviors *Enabling * Detachment * Taking care of it myself *Ask for help 5/11/12 8
  9. 9. Education: Believing the behaviors we see area choice supports the disease.  “I wish he would…….”  “Why doesn’t she………. “  “He should…… “  “If only she would…..”  “Why can’t he…..”  “Doesn’t she see ….”5/11/12 9
  10. 10. Education: Understanding addiction is adisease supports recovery.  Definition of disease  A disease is: a state of ill health with the abnormal function of one or more organs definable set of Si/Sx predictable course and outcome known or unknown cause5/11/12 10
  11. 11. Defined set of Predictable course & Si’s/Sx’s outcome Craving Loss of control Compulsion to use Continued use in spite of bad consequences5/11/12 11
  12. 12. Education: Addiction is a disease Why? (con’t) *Cause may or may not be known. Currently our understanding of addiction indicates two factors play a major role in the development of addiction. genetics and environmental factorsNature (genetics) loads the gun  Environment pulls the trigger However: there are addicts who have no apparent genetic predisposition nor significant environmental risks.5/11/12 12
  13. 13. Education: responding to the behaviors and not the disease supports the disease. Everyone/everything revolves around the addict - what they do and do not do. We work to connect with the addict - to maintain a relationship - by exaggerating our response to a behavior anger rage concern panic frustration retaliation authority dominance persuasion manipulation disagreement hostility * All these responses are motivated by: Fear5/11/12 13
  14. 14. Education: responding to behaviors and not the disease supports the disease. Anger: (often results from: fear, guilt, hurt) Three purposes: instruct the addict protect the addict make emotional connections Two kinds: protest against unkind or inconsiderate treatment hurts of the past and fear of the future The second is very nonproductive and harmful.5/11/12 14
  15. 15. Education: responding to behaviors and not the disease supports the disease. Perfectionism: unable to control the addict so keep everything else under control. Procrastination: sees disaster in everything they might do or try - so why even try. Caretaking: they take care of everything - pay the rent, make excuses, lend the car, buy the beer!!, clean up all the messes. Blaming: transfers responsibility to someone else - so I can wait until they get their act together. 5/11/12 15
  16. 16. Education: Enabling supports the disease.5/11/12 16
  17. 17. Education: definition of enabling:  Anything we do or do not do that gets between the addict and the consequences of his/ her use of drugs and/ or alcohol.5/11/12 17
  18. 18. Education: Enabling - why do we do it? Believe using is a choice. (remember the part of the brain involved) Believe using is a response to circumstances. Believe using is a lack of will power. Believe using continues because of a lack understanding of the consequences. Believe using is a moral short coming. Believing that doing something to correct these conditions will fix (end) the addiction and the behaviors.5/11/12 18
  19. 19. Education: Enabling behaviors5/11/12 19
  20. 20. Education: Don’t enable - detach which supports recovery.  Definition: is to separate ourselves emotionally and spiritually from the damaging effects of our relationship with the addict, to be objective. we can continue to love and care for them because we are detaching from their damaging behaviors not them learning to detach is difficult and takes practice and time -it is a process-5/11/12 20
  21. 21. Education: Don’t enable - detach to support recovery. (con’t) Practical applications of detachment: do not do things for the addict he/she should be doing for themselves do not save/rescue them from the consequences of their actions. (legal, financial, family, job, etc.) do not cover for their mistakes of omission or commission neither feel guilty nor responsible for their disease or actions. Detachment: is not getting emotionally wrapped up in the destructive behavior (the drama) - does not mean doing nothing 5/11/12 21
  22. 22. Education: We will take care of it ourselves supports the disease.  Common misconception: problems in the addict’s life are causing the addiction.  Common misconception: addiction is the result of a bad decision or an unfortunate turn of events.  So fix the “problems” - fix the addiction give him/her a fresh start provide for an education provide means to start a business  Try to “shake some sense” into the addict threaten, punish, relent - cycle5/11/12 22
  23. 23. Education: Get help/assistance which supportsrecovery and responds to the disease.5/11/12 23
  24. 24. Education: Get help/assistance which supportsrecovery and responds to the disease. First Step: Ask “Is what I/we are doing working”? or “Does it just seem like it should work”? Second Step: Be willing to admit I/we may be incorrect in our assumptions i.e. I/we are wrong/made a mistake!! Third Step: Ask “Am I/we willing to endure the pain/discomfort of change”? (in attitude, focus)5/11/12 24
  25. 25. Education: Get help/assistance which supportsrecovery and responds to the disease.  How/where do I/we get help/assistance? *Education: about addiction and codependency books, conferences, pamphlets, people in recovery (recovering families, recovering addicts), open AA mtgs. *Therapy: individual or family - therapist with experience addressing addiction and codependency *Mutual Support Groups: Al-Anon, Nar-Anon, Alateen, Families Anonymous, others * Interventionist:5/11/12 25
  26. 26. Conclusions  Remember:  1. You didn’t cause it, can’t control it, and can’t cure it.  2. Taking care of yourself is one the best ways to help someone else.  3. Supporting recovery is like planting seeds - it takes time to see results, you have to sow lots of seeds to get results and there could be a crop failure.  4. Get an education about addiction.  5. Ask for and accept help.  6. Set boundaries/limits - that you can and will enforce -be firm and specific.  7. Be certain the addict/alcoholic knows help and support is available.  8. Ask the addict/alcoholic ”How can I help you to support your recovery”?5/11/12 26
  27. 27. 9. And most important of all:Remember: “Addicts and alcoholicsare not bad people trying to be goodbut sick people trying to get well”. Connecticut Nursing News 3/02

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