By Roni Weisberg-Ross, L.M.F.T., Abuse Topic Expert Contributor

When we think of children who have been sexually abused, we think of fear, anger and violence. Most sexual abuse survivors talk of the terror and disassociation surrounding the abuse. Many still feel that way as adults and don’t enjoy sex now, even in a loving relationship. But there are those who have a more complicated story to tell. These survivors may have hated their abusers but experience an unspeakable shame over the fact that their bodies responded sexually to the abuse. They cannot live with the knowledge that they were sexually stimulated even as they were being raped. Now they are not only healing from the abuse but from the additional belief that they were partially responsible for the abuse - and that they may even have deserved it.

While adult survivors can intellectually understand that as children they were victims of their abuse, they don’t always feel that way. And they certainly can’t accept that fact if they responded sexually. Many of them can’t imagine how a child could respond sexually. So they believe that not only are they dirty, but that they are freaks as well. Yet children do have sexual feelings. Toddlers can sexually arouse themselves. And as they get older, many of them experiment and discover that their bodies respond. The myth that hormonal changes occurring at adolescence are the beginning of sexual feelings is just that, a myth. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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The “Bucket of Crabs” is one of our favorite analogies. Pulling crabs out of traps on Kodiak Island, we’d just toss them into a big bucket – no need to put a lid on the bucket.

Why not?

Because as soon as one crab would start to climb out, the other crabs would drag him, or her, right back down into the bottom of the bucket. There’s no escape to life back in the ocean. And that keeps happening until all of the crabs end up in the steamer.

The point? Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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Last month we wrote about the first two of the “6 Secrets Ex-Drinkers Know That You Don’t, And 12 Step Programs Don’t Want You To Find Out.” We started with the notation that AA/12-Step based programs, 98% of US treatment programs, are based on premises that both research and experience indicate are not only unfounded, but actually prevent you from getting over your problems and leave you with less than a 5% chance of recovery over five years.

Here are Myths 3 and 4:

Myth #3 - An Addict Must Hit Bottom

“Hitting Bottom” is a very destructive myth. Why would you wait until after you’ve lost you’ve everything to seek help? At that point, why would you bother to sober up?

Suppose for a moment that alcohol abuse actually were a disease. Then we’d be interested in prevention, then regular checkups, then early detection, then. Wait a minute…early detection? What happened to “hitting bottom?”

That’s the problem. With actual illnesses, we don’t wait until the patient is nearly dead before beginning treatment. Treatment is begun, good follow-up maintains progress, and changes in the patient’s life are instituted that will sustain the recovery. That’s an effective model.

It shouldn’t be surprising that this same process works well for diverting a client from alcohol abuse and dependence. The trouble is people have been discouraged - by mythology, stigma, and “lifelong recovery” - from getting help in the early stages when complete remission is not possible, likely, and relatively straightforward,.

How did that happen? Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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Last year we wrote a free download that we posted on our website entitled “6 Secrets Ex-Drinkers Know That You Don’t, And 12 Step Programs Don’t Want You To Find Out. It’s been popular, though not without controversy. Indeed, one Canadian who described herself as a “Therapist, Counselor, and Alcoholic” declared we were downright dangerous and had to be stopped!

That made us think we needed to get the facts into wider circulation so here’s a newly minted rendition of the first two “Secrets” for you consideration.

We started with the notation that AA/12-Step based programs, 98% of US treatment programs, are based on premises that both research and experience indicate are not only unfounded, but actually prevent you from getting over your problems and leave you with less than a 5% chance of recovery over five years.

Myth #1 - “You’re Powerless”!
What happens if or when you attend your first AA meeting? Shortly after you arrive you sit down and then one of the first things you’ll hear is that you’re powerless over alcohol. And just when you’ve finally taken the initiative to do something about your drinking problem, you’re told you’re powerless. Probably not exactly what you want or need. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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A colleague recently asked me for my assessment of the applicability of the “disease model” of alcoholism with regard to Native Americans. She asked not only because my adopted children are Inyupik, and from alcohol devastated families in northwestern Alaska, but also because I have worked in non-traditional ways of combating alcohol abuse for over twenty years.

My answers have evolved out of the past forty years of my experience, work, observations, research, discussion, and reflection.

To begin with, the repeatedly discredited “disease model” negatively impacts everyone suffering from alcohol abuse – not just Native Americans; and second, “Native American” is also a counter-productive term, one implying that there is only one homogeneous group indigenous to North America. Nothing could be farther from the truth.

To exemplify, Alaska alone, is home to three distinctly different “Native” groups: Aleuts; the Yupiks and Inyupiks (”Eskimos”); and over twenty different “Indian” tribes. Within and between these entities the degree of alcohol use and abuse varies widely and so do solutions to their alcohol related problems.”

However, it is true that across the continent, including Alaska and Canada, Native Americans do exhibit a higher percentage of alcohol abuse and dependence than many other groups, though again, not in every case. Still, given the high incidence it’s tempting to want alcoholism to be a disease, rather than looking for more complicated and less forgiving causes. However, regardless of the group being considered, alcohol abuse and dependence rates really are a reflection of an accumulation of contributing social, psychological, biological, and cultural factors. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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“Two things will be believed about any man whatsoever, and one is that he has taken to drink.” -Booth Tarkington

It isn’t unusual for people to seek treatment for their alcohol abuse problems when divorce is looming on the horizon. Indeed, probably two thirds of our clients come to us with crumbling marriages. What is surprising is that at a few of these clients don’t really have an alcohol problem and many of the rest are abusing alcohol, but aren’t alcoholics.

How does that happen?

Simply put, the treatment industry has promoted a Catch-22 model: if you’re accused of being an alcoholic and you agree, then obviously you are. But if you don’t agree then you still are – you’re just in denial. As Mr. Tarkington observed long ago, it’s a label that can be hurled at anyone and it will stick. And divorcing spouses like to use it just for that reason, it will stick and they will be able to leverage it to get what they want or at least make your life miserable for a while longer.

What is the reality? At a recent conference in western Canada, one presenter after another pointed out what a few of us have known for a long time, most people seeking help with their alcohol problems aren’t alcohol dependent “alcoholics” - they’re alcohol abusers who can be cured. But you won’t hear that if you go looking for help, or, God help you, an honest evaluation.

Why not? Because over 95% of all alcohol treatment programs are based on the assumption that you’re a powerless and diseased alcoholic, or you’re an alcoholic who’s in denial. Regardless, the outcome of any evaluation will be to put you in one of those two categories and “treat” you accordingly. It’s not an attractive prospect for anyone who actually cares about their future. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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Over the past decade research has found that for many women the onset of alcohol abuse coincides with changes in hormone levels – changes that many women are unaware of in the early stages. When this is combined with other stresses in their lives - job changes, health concerns, children leaving home - women can find themselves abusing alcohol for the first time in their lives.

In our teens, 20s and 30s, our ovaries and adrenal glands produce a form of estrogen called estrodiol. Later, during our mid to late 40s and early 50s, our ovaries begin producing less estrogen, leaving more of the work to our adrenal glands. As the adrenal glands take over the job, estrogen drops, spikes and drops again—rather erratically. At this point, many women report that they start to get forgetful and experience “foggy thinking” and moodiness. That’s because our brains work better when estrogen levels are steady. These are the first signs of menopause and, sometimes, the beginning of escalating alcohol consumption as a means of easing various unfamiliar discomforts. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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We recently returned from a conference on alcohol treatment called “New Perspectives.” The conference, hosted by Edgewood treatment center in Nanaimo, Vancouver Island, British Columbia, was, indeed, as advertised. Presenters echoed the same theme: the usual methods of “treating” alcohol abuse and dependence don’t work. While this isn’t news to some of us who’ve looked at the statistics for over twenty years, it is the first time we’ve ever attended a conference that wasn’t hyping the same old failed models. Perhaps being Canadian – a country not quite as enamored with the Minnesota 12-Step Model – helped. Whatever the case, it was a refreshing change. Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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We work with clients very intensively – four or more hours a day for five to seven days – and with a well defined presenting problem – alcohol abuse. Following this initial treatment phase, during the ninety days of follow-up, we frequently see family members sabotage progress once clients return home. Undermining progress is rarely intentional, but nonetheless it is the second most common factor in clients reverting to old behaviors. Only clients’ self-sabotage is more destructive. Combine the two and any progress will be stopped dead in its tracks.

Why do spouses in particular, but other family members as well, attempt to drive clients back to their old drinking behaviors – behaviors they claimed they wanted changed, and whose elimination they frequently demanded? The answer is that, unhappily, we all tend to find that we really like what we refer to as “the security of familiar miseries.” Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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Have you ever been told a person has to “hit bottom” before they can begin to recover? What do you suppose that even means? Exactly what is “hitting bottom?”

Do you suppose it’s really a good idea to wait until you’re divorced, or bankrupt, and/or facing another DUI before looking for an answer to your drinking problem? We don’t think so.

The concept of waiting to hit bottom isn’t just useless – it’s dangerous. How? Consider how that tenet would play out in the case of a real disease, cancer.

“Well, you know,” they’d say, “you really can’t do anything about cancer until it’s metastasized.” Huh?

But that’s most alcohol treatment providers’ party line.

Let’s look at alcoholism as if actually were a disease. What do we know about real illness? Well, first there’s prevention, then there’s regular checkups, then early detection, then… Oops. Early detection? What happened to “hitting bottom?”

Of course that’s the problem. With illness, we don’t wait until the patient is nearly dead before beginning treatment. Effective treatment is begun, good follow-up maintains the progress, and changes in the patient’s life are instituted that will sustain the recovery. It shouldn’t be surprising that this same model works well for diverting a client from alcohol abuse and dependence. The trouble is people have been discouraged – by mythology, stigma, and “lifelong recovery” - from getting help in the early stages when remission is not only possible, but likely.

How did that happen? Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

Click here to contact Mary Ellen and/or see her Profile
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When we were scratching around wondering what to call our counseling practice we coined and rejected a lot of possibilities. Some names we considered were obscure, some taken, some boring, and a few were just plain silly. Then we took a look at what it is we actually do, and what we don’t do. The main thing that separates us from most alcohol rehab programs is the fact that we don’t have a “program.” What we do have is a lot of experience and research into what works for different people. The primary offering we have for our clients is the certainty that the solution to their specific problems and set of circumstances will be, like themselves, unique – it will truly be their empowering solution, not ours, or AA’s, or Moderation Management’s, or someone else’s canned prescription. We don’t dictate, we help you find Your Empowering Solution.
Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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There are many types of alcohol consumption ranging from the healthy to the deadly. Some people of the prohibitionist persuasion will ague that any use is destructive, but neither medical research nor personal experience supports that conclusion. Unhappily, most “screening” protocols are heavily weighted towards a diagnosis of addiction justifying punitive treatment approaches and “abstinence only” outcomes. In reality, many different degrees of alcohol use exist, and the following thumbnail guide can be helpful in deciding what category is appropriate, and in predicating various – as well as usual - outcomes.

Healthy alcohol consumption has been found to be approximately two drinks of distilled spirits, two bottles of beer, or one half bottle of wine per day for an adult man, and half that for an adult women. These amounts confer the most health benefits without any associated detrimental effects. Obviously, not everyone consumes these set amounts, nor do most people who drink necessarily always stop at one or two. Certain social settings may find one consuming more over the duration of an event, for example, but the average should remain within the recommended parameters.

People who clearly fall into this category may, unfortunately, still find themselves in need of help. Particularly in child custody disputes, but in other legal matters as well, unfounded accusations are frequently hurled and difficult to refute. As John Donne noted, “Two things will be believed of any man whatsoever, and one is that he has taken to drink.” Read the rest of this entry

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

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Between us, we have been helping people get over alcohol related problems for over twenty years. Sometimes it’s his or her own use, sometimes a friend’s, family member’s, or employee’s. We’ve always helped each client to find their own unique solution to whatever troubled them. In the course of thrashing around looking for these individual answers we’ve learned a lot about what works and what doesn’t and for whom.

The first lesson learned is that nothing works for very many people – AA and the other 12-Step based programs have about a 5% abstinence rate over one year, and less than 1% over five years. Other one-size-fits-all and abstinence based programs have similar rates as far as anyone can tell. Read the rest of this entry