Month: October 2024

Holiday Strategies for Staying Clean and Sober

People in early recovery bring all sorts of hopes and fears into the holiday season.  One minute we can be excited to be part of the family again.  The next minute we flood with shame about the past.  We can still struggle with inner loneliness and often feel apart-from rather than a-part-of family. We try on our recovery crusader cape and get ready to recruit others in the family.  Our emotions and energy levels still react like a roller coaster.  We fume and defend ourselves in our minds against the family that probably only wants to talk about our mistakes and won’t give any credit for our new sobriety – at least we imagine the family wants to criticize us.  Just to be prepared, we stake out a defensive position.

But really, staying clean and sober and sane through the end of 2018 has nothing to do with family or holidays.  We stay clean and sober when we are willing to try and to do whatever it takes to keep our sobriety.

Suggestions don’t keep us clean; our willingness to try the suggestions is what keeps us clean.

1. Go to bed clean and sober.

No kidding, it’s the only way to put together time in recovery.  Doesn’t matter if you go to bed clean and sober for the right reasons or for the wrong reasons.  Does not matter if you go to bed clean and sober with the right attitude or the wrong attitude. Doesn’t matter if you go to bed clean and sober after your mother kept her opinions to herself or your mother kept asking in front of the whole world why you have such bad acne.  Does not matter if you go to bed clean and sober having had a good day or the worse day of your life.  No kidding.  Go to bed clean and sober.

2. Go to tons of meetings

Go to tons of meetings. People whine at meetings? They tell the same stories over and over again? No one ever asks you how the meeting should be run?  Doesn’t matter.  Go to tons of meetings.

3. Binge on Netflix

Binge on Netfix. Seriously, we now know that humans are meant to find escape in binge tv. Otherwise, why would a major corporation be dumping 13 episodes of a series all at once on a Friday afternoon?

4. Stay away from old places and old habits and old friends.

Our disease will tell us that we’ve been clean long enough to hang out with that guy.  The disease lies.  We need to keep doing all the things that have helped us get and stay clean and sober AND we need to keep not doing all the things that haven’t and shouldn’t have been part of our recovery.

5. Reach out

Reach out to another person in recovery who is more alone and more fearful than you. Then the two of you together go find someone in recovery who is less alone and less fearful and just hang out, between meetings.

6. HALT

Watch out for the HALT times when you are hungry, angry, lonely, or tired. Dehydration can be a bitch too.  If you are hungry, eat.  Lonely, call people in recovery.  Angry, forgive.  Tired, take a nap.  Thirsty, drink a glass of water. (Trolling your ex’s Instagram account didn’t make the list of suggestions.)

7. Chill

Don’t try to resolve your past during the high drama of holiday season. Holidays aren’t real life, which is why they are called holidays.  Wait until real life days to address your dad’s lack of trust or to make promises about the future or to make apologies about the past.

8. WAIT

Practice the WAIT question: Why Am I Talking?  If you feel the need to talk, say to others, how are you?.  Say please and thank you.  If you’re a jerk, pretend you aren’t.  That’s not a suggestion to be dishonest; it’s a suggestion to be courteous.

9. Pray

Prayer isn’t an effort if we believe in some sort of higher power and then actually pray.  But what if there is no such thing as a higher power?  Why would we want to waste our time? Because in recovery we should become as willing to try prayer as we were to try a new drug. Very few of us ever turned down an offer to get high because we weren’t sure the drug was legit or because we didn’t want to waste our time snorting what might turn out to be baking soda.  Be as gutsy with God as you were with drugs.

10.  And finally…

And most important, go to bed clean and sober. Even when you don’t want to, or when it sucks, or when you feel alone.

Because the greatest holiday gift we can give family is the gift of time in recovery, the gift of racking up days.

“There are many paths to the top of the mountain, but the view is always the same”
-Chinese Proverb

If you have ever taken a long hike up a mountain, you are no stranger to the many twists and turns you may encounter on the way to the top. If we liken climbing a mountain to this spiritual journey we call life, we can draw many parallels. On the way up, there may be many factors that influence the path you take – many trail options, trail markers offering different paths with no warning of what each holds, huge puddles of mud, seemingly insurmountable aggregates of sharp rocks, exhaustion, your internal voice whispering “you can’t make this, you’re too tired” – but the 360 degree view from the top always seems to make the extra effort worth it. As we traverse the twists and turns life throws at us, we often find that the outcome is in many ways different than we could have ever imagined, yet much more rewarding and fulfilling.

Here in the Riverbank House Community, we embark upon our journey with many choices to consider and decisions to make. Should I try yoga? Will I be able to last 20 minutes in a silent meditation? Is it possible to overcome the discomfort I feel within? Without an open mind to explore the many paths to recovery, we find it difficult to envision the view from the top provided by overcoming the unknowns we may face on the way to our destination. With the encouragement and support from the men around us, we find that slowly, but surely, we gain confidence to navigate the uphill climb by following the roadmap provided and walking on the many trails ahead. With new experiences we gain new perspectives, and with new perspectives come new possibilities. We dig our heels in to find the internal voice which tells us “Keep pushing – you’re on the way”. As we conquer our first metaphorical climb, it becomes possible to see the peaks of the surrounding mountains, some smaller and some larger. We walk together and accept the new challenges with our newly-found confidence –at each summit taking a moment for a deep breath and enjoy the view.

Solo No More — The Riverbank House Recovery Community Retrospect

August 30, 2018 by Jessie Brooks-Janzen, MSW (reprint, lightly edited for format)

I work with Individuals and Families impacted by Addictive Behavior.   That work often entails exploring treatment options for loved ones.  Finding the right recovery community or program can be difficult and overwhelming.  There are many of questions and concerns.  Is it worth the money?  Why would I want to go there for help?  Will my loved one find recovery?  Inpatient or Outpatient?   As a result, I carve out time in my practice to visit treatment programs.  I visit both in state and out-of-state programs so I can do a preview prior to recommendation.

I recently visited Riverbank House recovery community in Laconia, NH to review their program for the Individuals and Families I work with here in Seattle, WA.  Some families might ask, why would I send my loved one so far away for help?  And in all honesty, I thought to myself – would I really recommend sending someone that far from home?

And in one word my answer is, “YES.”

Why the Riverbank House?

Recovery community promotes recovery success.

Riverbank House consists of multiple historic homes lining two sides of a gentle river.  Unlike many rehabs, this recovery community defies the stereotype of a clinical, sterile, lock down setting.  Residents fully integrate into the larger community.  Residents shared with me that a large part of their recovery is not only about learning how to stop addictive behaviors.  These men also learn how to live life again within the community by building and practicing important skills.

Social Skills

Addictive behaviors thrive best when a person is solo, with no accountability and in isolation. Regular contact with environments, friends, and family would counteract addiction. Therefore, a key support that is provided for each new resident at the Riverbank House is a mentor for their duration of stay.  The mentor is a more senior resident who is further along in their recovery.  Their job is to partner with the more junior resident.  They introduce it as the concept, “Solo, No More.”  Part of an individual’s recovery is learning how to live in community again.  When you are in a therapeutic community with accountability and mentors, addictive behaviors cannot thrive.

Life Skills

Practical life skills are challenging for individuals in active withdrawal.  Detoxing makes everyday tasks even more difficult.  Having a safe environment with others to support and encourage you is key. Residents live in homes, typically 2 roommates to a room,.  They have household responsibilities and a daily schedule to follow.  Essentially, many are learning the basics on how to live life without substances.  They retrain their brain, bodies, and emotional selves that substances are undermining their daily life.  Routine, mentoring relationships, accountability, and time help residents build these life skill muscles that have been idle, while they were in their addictive behavior.

Emotional and Mental Health

The emotional and mental health of an individual struggling with addictive behaviors must be addressed in order to achieve recovery.  An important part of the Riverbank Program is their philosophy that there are “many pathways to recovery,” which encourages residents to be open to new ways of living by participating in meditation and mindfulness, process groups, yoga, 12-Step, SMART Recovery, Relapse Prevention, etc.  Stopping the behavior is only one piece of recovery – understanding what, why, and how is the foundation that will help the individual sustain recovery.  Therefore, these varying options provide residence an opportunity to explore what are the triggers that may lead to relapse? What tools can be used to cope with urges?  Why did I engage in addictive behaviors?  How can I sustain my recovery?

Vocational and Educational Pursuits

Continuing education and finding employment is something residents also work on while at the Riverbank House when they have sustained 5 months or more sobriety.  This is another key aspect to a residents recovery, because for many they may have lost employment or stopped education, as their addictive behaviors encompassed them. There are many employment opportunities and experienced provided:  Woodworking, Construction & Landscaping, Karma Café & Art Gallery, Yoga & Fitness Instruction, etc. There is also a Lakes Region Community College minutes away for residents who would like to continue their education, while living in a sober environment.

Recovery Is Not a Sprint; It’s a Marathon

I often share with clients who are grieving the loss of a loved one that there is no timeline on grieving.  I also believe this to be true when talking about recovering from Addictive Behaviors for both the Individual and their Loved Ones.   28 days, 60 days, 90 days – Recovery is a life long commitment – it is a training program for all involved.  Old behaviors need to be replaced with new ones that strengthen Recovery.   Skills develop over time while the body, mind, and spirit heal.

And Riverbank House “places no limit on the duration of stay.”  What this means is that residents are encouraged to stay longer than the initial commitment that residents make – some say, “I’ll try it for 28 days,” most stay beyond that initial commitment of 28 days and find that the length is key to their recovery.  Effective treatment takes time, because it requires time for healing a persons whole self – mind, body, spirit.  Experts and evidence-based providers are finding that long term care and continued care promotes long term recovery.

Please feel free to reach out to me if you have questions about my experience at Riverbank House or are in need of Individual or Family Counseling.  1417 NW 54th Street #462 Seattle, WA. 98107  | 206-905-9931| msw@jessiebrooksjanzen.com

The complete article.

Addiction Recovery’s 1st Step

When chronic drug users and alcoholics separate from an addictive substance they often need help coping with withdrawal.  Detox is a popular umbrella term in the lingo of addiction recovery services, but new terms are emerging.  The Substance Abuse and Mental Health Services Administration defines crisis stabilization as

a direct service that assists with deescalating the severity of a person’s level of distress and/or need for urgent care associated with a substance use disorder.

Addiction recovery vocabulary can be confusing.  Any time an alcoholic or drug addict (especially an opiate addict) slowly or abruptly stops using – whether voluntarily or due to circumstances – the addict will experience some form of withdrawal.  When a person addicted to drugs or alcohol seeks recovery services for the symptoms of withdrawal, the process is called detox or crisis stabilization or medically managed withdrawal.  So the services that fall under the umbrella term “detox” always involve withdrawal but withdrawal doesn’t always involve “detox”.

What Detox Is And What It Isn’t

According to the federal Department of Health and Human Services, important key characteristics of successful detox and crisis stabilization are:

• Detoxification in and of itself does not constitute complete substance abuse treatment.
• The detoxification process consists of three essential components: evaluation, stabilization, and fostering patient readiness for and entry into treatment.
• Detoxification can take place in a wide variety of settings and at a number of levels of intensity within these settings; placement needs to be appropriate to the patient’s needs.
• A successful detoxification process can be measured in part by whether an individual enters and remains in some form of substance abuse treatment after detoxification.

Drug or alcohol detox and crisis stabilization are good places to start the road to recovery from addiction, but it’s crucial that we understand they are only the beginning.  Because drug addiction and alcoholism are chronic, life threatening diseases that require life-long management, recovery is a marathon rather than a sprint.  And as a beginning to that marathon, prescription drug or alcohol or opiate detox is the part where a marathon runner puts on the sneakers.

Addiction Science Experts Agree

The Center on Addiction and Substance Abuse at Columbia University:

Detoxification is an important step in the recovery process, but it is not treatment for the disease….Drug and alcohol detox is only as effective as its follow-up care.

The National Institute for Drug Abuse:

Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use….It is important to know that detoxification is not treatment; it is a first step that can prepare a person for treatment.

Substance Abuse and Mental Health Services Administration:

Detox alone with no follow-up is not treatment.  Treating withdrawal is not the same as treating addiction.

Successful recovery from addiction requires a continuum of care. Addiction treatment takes time. And sustained recovery from addiction or alcoholism requires a lifetime of maintenance, commitment, and vigilance.

When trying to overcome any challenge in life, being confident and believing in yourself is one of the most important focuses. It can be nearly impossible to overcome a challenge when you repeatedly tell yourself “I cannot accomplish this”. When your inner monologue is consistently self-doubting, your brain and body begin to believe the things you tell yourself. With the lack of faith in your abilities, you eventually stop working diligently to overcome the challenge you are facing.

The challenge we face in this case is addiction. Addiction is something so many of us struggle with, but often are unsure how to begin to tackle the challenge of getting, and staying, sober. The action begins in the mind, specifically with a “growth mindset”. A growth mindset is believing that you are in control of your own life and choices. With this perspective, you give yourself the power to own your recovery and take the necessary steps to get well. You are in control of being able to learn and improve. Thinking and living according to a growth mindset allows you to expand the realm of what is possible when it comes to recovery and confidence begins to grow.

What exactly does a fixed mindset look like? A fixed mindset is when a person believes that any given situation or personality trait is unchangeable. This mode of thinking is dangerous because it leaves a person with little hope that he or she will be able to make positive changes, and have a feeling that the situation or trait will be the same for the rest of his or her life. This can be especially dangerous for an addict. A fixed mindset in addiction might sound like “I am an addict” or “I am a bad person.” Reframing fixed thoughts is extremely important when beginning the journey to recovery. “I am an addict” can be changed into “I am a person with addiction, but have the ability to recover”, and “I am a bad person” can be changed to “I have made bad choices, but through recovery I can learn a new way of life.”

Recovery from addiction is no easy feat. Having your brain and body work against your efforts can be especially difficult to overcome. One must first have hope that he or she can recover before the action is deemed to be a worthy endeavor. Recovery takes HARD WORK. It is difficult to overcome the challenges early recovery throws at you if you are constantly telling yourself “I cannot do this.”

Recovery, like a herd of turtles stampeding through peanut butter, is a gradual process. Every day has its ups and downs, but some things you can count on – like eating. I find cooking to be therapeutic, even meditative. My mindfulness increases with the smell of freshly pressed garlic, or the sensation of tearing up while cutting into raw onions. Tasting throughout the cooking process reminds me where the ingredients came from and where the dish is going.

To get out of the pan for a moment, let’s compare cooking and recovery. When reduced to a chore, both cooking and going to meetings can become tedious. At the bare minimum, chicken can be plainly baked with some chopped lettuce on the side. Sure, it gets the job done, but there is potential to be so much more, like an aromatic chicken pozole topped with bright, red radishes. Similarly, we can sit silently at the back of a room for an hour, listening to people talk, or we can engage with other folks at the meeting. Sharing and relating in company of others, just like eating together, can be surprisingly satisfying.

I’m very grateful to make the most out of my opportunity at Riverbank. The raw ingredients and the tools (both in recovery and in cooking) are provided and the rest is what we make of it. All the grocery shopping and all the cooking is done by teams of residents. After all, these life-skills must be used to maintain a well-balanced, enjoyable life. Otherwise, recovery slips far too easily into an obligation rather than an opportunity to help yourself and others. Tonight’s menu is Ropa Vieja, the national dish of Cuba, with slow cooked beef topped with roasted red peppers, green olives, and capers. If you’re going to cook some food, cook some food. That’s how this foodie sees it, at least.

Recovery requires courageous remodeling of the pleasure-reward pathway. This mesolimbic system, in neuroscience terms, is a pathway of neurons that we rely on every day. It’s what drives the mouse to forage, the frog to call out for a mate into the night, and prioritizes our pleasure-seeking lifestyles. The pursuit of happiness. Typically, this sets up a system of checks and balances of pleasure and pain that motivates us. And it works, until something easier and faster comes along.

Chemicals have hollowed out an unhealthy trench of neural circuitry in my brain that seems like an obvious way to numb out stress. More convenient, too, because it’s path of least resistance. Sobriety is like carving out a new route with a spoon. Positive experiences in sobriety fire off new neurons or reignite old ones, slowly creating new neural networks to redirect the stream of life away from the trough of addiction. I’ve fallen back into that pit many times. Somehow, I thought it will be comfortable. But where I expected a goose-down mattress I found a craggy bed of rocks.

I am learning not to let my failures define me. Success starts when I wake up and decide what kind of day I’m going to have. Setting it up right seems to be key. Before engaging with any technology, I set aside time to perform little rituals to keep myself in the right state of mind – making the bed, meditating, eating a good breakfast, etc. That keeps the chaos of the outside world from dictating my thoughts and emotions. I don’t always need to see someone else’s depiction of life – sometimes reading the book myself is better than watching the film. It also leaves a little room to daydream. That’s how this star-gazer sees it, anyway.

Some days I feel like a long-tailed cat in a room full of rocking chairs. Nervous and unsure where to go next. This happens when I start missing the forest for the trees. There’s a saying in pathology: “everything looks scary under high magnification.” Meaning I could be looking at healthy lung tissue, but at high magnification the larger picture gets obscured and I focus too much on small details. The small details then skew my perception of reality and I start seeing disease in normal tissue.

Overreaction to details in recovery can be deadly. When I lose sight of the bigger picture, I lose confidence. I forget the peace of mind that comes with relying on my Higher Power. As soon as I get lost in those little particulars and then I’m overwhelmed.

One thing things I’ve learned at Riverbank is how to take a second and breathe. Meditation teaches you that breathing is one things you can always control in life, and it centers me. Remembering to breathe in crucial moments of stress can prevent a hectic day from becoming a downward spiral. That’s how this pathologist sees it, anyway.

Staying sober in rehab vs. in recovery presents different challenges. For me, it’s relatively straightforward to remain sober in rehab because there’s a safety net and daily reminders. The difficult part is keeping sober in recovery. Applying the toolkit provided in rehab isn’t so simple without the constant reminders of your disease. Talking about 12-step work is one thing, using it when no one else is looking is another. The outside world can be as wild as an acre full of snakes.

The phrase ‘pink cloud’ is thrown around in rehab, and it means you feel good without substances in your system. Your mind feels clearer, and your peers are just a stone’s throw away. Anytime you are struggling it’s easy to knock on your neighbor’s door and talk it out. But beware of falsely inflated confidence, because out there in the default world your peers are a phone call away and sometimes that phone can feel as heavy as an anvil.

Forging healthy coping skills is essential for success in sobriety. Learning how to integrate work and social life while keeping sobriety as priority number one must be achieved. At Riverbank, it’s inspiring to have the opportunity to set the foundation for the default world in a safe environment because it instills confidence and encourages practice. I witness my peers building this gateway to that they don’t have to leave the pink cloud behind. Instead they keep with them a pink bubble that shines like a beacon onto other folks in sobriety. That’s how this brick-layer sees it, anyway.

Drug addiction is as dark as the inside of a wolf. This chronic relapsing disorder is characterized by maladaptive learning about drugs and predictive cues that leads to compulsive drug seeking. The crucial goal of addiction treatment is to correct maladaptive behaviors and minimize relapse events without disrupting normal reward-seeking behaviors (like finding food and water). Because drugs hijack endogenous reward circuitry to elicit their rewarding and reinforcing effects, this proves difficult.

Enhanced activation of substance specific reward and reinforcement pathways, such as the dopamine system, can lead to remodeling of neural circuits as well as changes in synaptic connectivity that increase rewarding-seeking connections while decreasing plasticity, or the ability to reform healthy decision making circuits. Accordingly, individuals put enormous amounts of disproportionate effort into working to obtain drug at the expense of other adaptive behaviors. Thus, the inability to update information and extinguish maladaptive behavioral responses forms the basis of pathological drug seeking that often underlies relapse.

Relapse can happen, and it hits like a sack full of hammers. All of that detailed, scientific characterization of the neurological basis of addiction can be daunting. But what I’ve bore witness to at Riverbank fills me with hope – courageous men picking up the tools to change those maladaptive behaviors. It’s infectious and inspiring to be surrounded by those so determined to change their lives for the long term. All of elements are there, now it’s time to write the novel. That’s how this storyteller sees it, anyway.