Loss

I'm aware that the recent loss of a client has been difficult for some staff who worked with him. It brings to mind two quotes. The first is from Bill White and has been posted here before:

Another unique quality of the addiction counselor is the capacity to absorb losses and use such losses as rituals of rededication. The high mortality rate of alcoholics and addicts means that addiction counselors experience many losses, some of them quite horrific. To sustain oneself in the face of such losses requires the ability to use these experiences to deepen one’s understanding of the nature of addiction and to recommit oneself to finding new ways to reach those who have not yet achieved stable recovery. To fail to master this ability is to open oneself up to emotional injury and the protective detachment or over-involvement that such injury can spawn. Seasoned addiction counselors are acutely aware that they are involved with their clients in a life-or-death struggle for recovery. The stakes involved in this work are very high and that awareness brings its own burdens and rewards.

The second is from a card that Jim made for staff 13 years ago after a very bad week at the Farm:

At times like these, it’s easy to lose sight of what is true.

Be reminded today that you are a HELPER & HEALER

“Compassion is a spirituality as if creation mattered. It is treating all creation as holy and as divine…which is what it is.” (Matthew Fox)

Support each other, take care of yourself, and don't lose sight of the fact that your work creates space for incredible transformations in the people we serve.

New CAAC

Cassie James just received certification as a CAAC. Congratulations Cassie!

Confrontation

I got a sneak peek at an upcoming article on confrontation. I've been asked not to circulate it until it's published, but there are two sentences I'd like to share:

In its etymology, the word “confront” literally means “to come face to face.” In this sense, confronting is a therapeutic goal rather than a counseling style: to help clients come face to face with their present situation, reflect on it, and decide what to do about it.

One of the key points of the article is that confrontation is an appropriate and important treatment goal, but confrontation as a technique or style actually hinders achieving that goal.

Are there ways to you, your program, or your coworkers use confrontation as a technique that interferes with confrontation as treatment goal with the client?

Another response

I have thought a lot about this because of that Bill White quote. I always assumed that an addict needs to get into enough pain so that it outweighs the fear of change. For me, I was not in any more "pain" when I got sober than I had been for years before, but something was obviously different and I don't think that most of it happened before I got into treatment. Treatment was just a safe place to go to regroup. To be willing to let go of everything that I thought I knew for my whole life and try something different there had to be hope. It was definitely a cumulative effect, looking back I took something from every one of all my past experiences in treatment and AA, even all of the times that I was not doing the deal. The fact that I had nowhere to go, warrants for my arrest and it was Feb. all helped me stay in treatment. I remember being in the first month of treatment the last time and thinking I was doing a great job but people telling me I was toxic and negative. Thank god I wasn't discharged for it.

Residential Aide Meeting

There will be a residential aide meeting on Wednesday, June 6, 2007 @6pm at the Dawn Farm Barn. Food and drinks will be provided. All residential aides are asked to attend.

A response to Another Discharge Lesson

A response to Another Discharge Lesson:
My first thought when reading this post was that sometimes all we need is a little more pain to succeed. I know that for me I had to use a few times after entering my first treatment program, I also needed to experience more pain. I was not serious about staying sober until I was discharged from the farm -which was my 4th time in treatment. At that time I realized that I better shape up because I may burn all my bridges if I didn't and that experience caused me to dive head first into Alcoholics Anonymous. Maybe in this case it wasn't that treatment wasn't the answer but simply just a case of needing more pain. I'll never claim to know for sure but just an idea.

My response:
Thanks for your thoughts. This response may go well beyond what you said or thought, but just bear with me.

I think most of us find that some kind of "motivational crisis" was critical in our achieving recovery. For a lot of us it's anxiety triggered by pain. This is probably more true for younger "high bottom" addicts. However, as Bill White points out, a lot of our clients have experienced pain that I can't imagine--they don't need to hit bottom, they're living on the bottom. If pain was the gateway to recovery we'd all recover eventually. Why some people get it and others don't is a question that doesn't have any easy answers and, in many ways, is less and less clear the longer I'm sober and the longer I work in the field. (I spent a lot of time over the years thinking that I just wanted it more, I was more willing, I decided that I had suffered enough, etc.)

I think that we need to be careful to avoid thinking that our clients need to suffer their way into recovery. I've seen and engaged in more troubling (un)professional conduct than I care to think about. All justified by thinking that addicts learn through consequences and pain, and that they "just need to make a decision." It took me years to recognize that, if it just takes a decision, we're not really powerless. I really drifted into a criminal justice or moral mentality that our clients were selfish, self-indulgent, short-sighted, etc., and just needed to be good. I thought that my value as a recovering person was that you "can't bullshit a bull shitter." In assuming that posture, I sacrificed the true value of being a recovering counselor--the ability to empathize with the shame, fear and isolation my clients were feeling.

Here's something from Bill White on the subject:

What the addiction counselor knows that other service professionals do not is the very soul of the addicted — their terrifying fear of insanity, the shame of their wretchedness, their guilt over drug-induced sins of omission and commission, their desperate struggle to sustain their personhood, their need to avoid the psychological and social taint of addiction, and their hypervigilant search for the slightest trace of condescension, contempt or hostility in the posture, eyes or voice of the professed helper.

The relationships between the addiction counselor and his/her clients have much in common with other therapeutic disciplines, but there are qualitative differences. Addiction counseling has had a greater respect for the power of unseen forces in the recovery process, particularly processes of sudden, transformative change (see Miller & C'de Baca, 2001). The field has also had a sustained interest in stages of change processes (see Wallace, 1974). Studies of addiction have generated the models of change that have are now being applied to many other problems (Prochaska, DiClimente, & Norcross, 1992). One also finds interesting areas of emphasis in the addiction treatment world that are less visible in other disciplines, e.g., the value of catalytic, sense-making metaphors; the importance of narrative reconstruction of personal identity and interpersonal relationships (via story reformulation and storytelling); positive and culturally nuanced reframing of abstinence; and a deep appreciation for paradox ( e.g., strength coming out of weakness, winning by admitting defeat).

...

If there is a therapeutic stance most unique to addiction counseling, it is perhaps the virtue of humility. Alcoholics and addicts have long possessed ingenious ways of instilling such humility in therapists who saw themselves in control of the therapeutic process. While seasoned addiction counselors muster the best science-based interventions, they do so with an awareness that recovery often comes from forces and relationships outside the client and outside the therapeutic relationship. It is in this perspective that the addiction counselor sees himself or herself as much a witness of this recovery process as its facilitator. In the end, the job of the addictions counselor is to find resources within and beyond the client (and the counselor) that can tip the scales from addiction to recovery. To witness (and be present within) that process of transformation is the most sacred thing in the field, and what would most need to be rediscovered if the field collapsed today.

Employee of the month

Robin Edison is our May Employee of the Month. Robin comes to work every day with a positive attitude and full of energy. She's been getting training on Dialectical Behavior Therapy, training other staff and implementing use of these skills at the Farm. Along with Ed McSwain, she has worked hard to steadily improve the family education program.

I have one story that's a great example of her attitude. We had to discharge a client late on a Friday afternoon after what had already been a particularly rough week at the Farm. (We had lost several clients that week.) Due to all sorts of legal and family entanglements, she ended up staying 3 hours late to make sure the client got to where she needed to be. The client's attitude was horrible, and the court personnel were worse. Robin was unwaveringly respectful and supportive of the client, and she never complained or even sighed about having to stay 3 hours late on a Friday after what had already been a very long week.

Thanks Robin!

Volunteer of the month

Erica Genheimer is May's Volunteer of the Month. On any given afternoon you could bump into Erica in the Farm office - because every week she is there, faithfully helping out Ashley and Jim on mailings and other office activities. She already has a busy life, but Erica regularly helps us get out mailings on time - and she is a joy to have around. Erica really brightens our days!