Blogging on Good Therapy

By Sarah Jenkins, MC, LPC

Click here to contact Sarah and/or see her GoodTherapy.org Profile

At a recent event, I had the joy of watching a boy, no more than seven years old, exploring his world. His energy sparkled and his spirit was pure; he was an “old soul,” to say the least. As part of a “quest” he was asked to bring back the answer to the question “what is wisdom?” He waited patiently as my friend and I considered our reply. The answer was painstakingly difficult, and at best, only touched the surface of wisdom’s substance. “Wisdom is knowing and doing the right thing, even if it is the hardest thing to do.” Off he went, and there we stood, dumbfounded.

I continued to ponder the boy’s question, and our brief answer. I considered how often the universe asks us to do the wisest thing, which is often the thing that hurts the most. Yet, our humanness, and our desire to not suffer, or see others suffering, blocks us from doing that very thing. Instead of pushing through the pain, facing it, exploring the suffering, some chose not to do the wisest thing. It can seem counter intuitive. The wisest thing can be, in actuality, the choice that would hurt the most, initially, even if is more helpful in the long run.

Maybe you know that something in your life is not healthy, right for you, or even puts you in danger. Wisdom tells you “I need to stop this,” but the expectation of the pain from that decision over rules you. Instead of listening to your inner wisdom, you allow the fear of the suffering to take over. You do nothing, or the same thing. We do suffer, and will, but it is at the other side of suffering that wisdom develops. Wisdom comes from experiencing what is difficult, surviving it, healing from it, and ultimately, integrating what is learned. (more…)

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
Click here to contact Ed and/or see his Profile

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.
(more…)

By Patti Desert, LCSW

Click here to contact Patti and/or see her GoodTherapy.org Profile

When the news broke about New York Governor Eliot Spitzer’s alleged involvement with a prostitute the nation was inundated with newspaper reports expressing shock and confusion. Politicians, corporate executives, and various other pundits were outraged by Spitzer’s behavior? And healthcare providers began scratching their heads at the apparent level of ignorance about addictive behavior that these responses demonstrated.

In fact, Spitzer’s behavior is a classic reflection of a particular kind of addiction known as sex addiction.
(more…)

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
Click here to contact Ed and/or see his Profile

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.” (more…)

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
Click here to contact Ed and/or see his Profile

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. (more…)

by Mary Ellen Barnes, Ph.D.

Click here to contact Mary and/or see her GoodTherapy.org Profile

The conversation began easily enough, “My brother is bleeding our parents into the poor house with his unending demands for money - money to support his addictions – and they don’t seem able to stop giving it to him, even though he isn’t getting any better. What can we do?”

Or we hear from the parents themselves, “How can I get my spouse to stop giving our adult daughter money she just spends on booze or drugs? Her promises are worthless and the demands endless.”

It’s not an uncommon condition. Parents are living longer, some adult children make childishness a career, and it isn’t easy to say no to a son or daughter, regardless of their age. Then add in the grandchildren, hostages held for ransom as your child essentially blackmails you into supporting their drug and/or alcohol abuse: “Give me the money or I will kill myself,” or “they will starve,” or “we’ll be on the streets,” is the implied or actual threat, yet the money does no good. (more…)

by Edward W. Wilson, Ph.D., MAC

Click here to contact Edward and/or see his GoodTherapy.org Profile

As a family member becomes increasingly alcohol dependent, most families find themselves wishing they knew what to do. Initially we all tend to look the other way and hope that we’re wrong, but eventually most of us will start getting angry as the side effects begin to spill over into our lives. Then were also, probably, going to feel guilty about being angry. It is, after all, a disease, isn’t it? How can we be mad at someone who is ill?

Lewis Thomas, M. D., essayist and late Director of Memorial Sloan Kettering Cancer Center, once wrote that in medicine the most difficult part is knowing that “frequently the best we can do is to stand back and quietly wring our hands.” For many of us, that is how we respond as the problem grows. And sometimes it is the best that can be done. (more…)

Written by Edward W. Wilson, Ph.D., MAC

Click here to contact Edward and/or see his GoodTherapy.org Profile

Non-traditional alcoholism treatment methods have always recognized that 12 Step models work for some individuals but not for most, at least not for very long. The problem is that nothing else seems to either. Designing effective treatment for individuals turns out to be a complicated business that must take into account many variables in ways that don’t easily lend themselves to any particular model. As a result most programs offer little beyond “don’t drink, go to meetings, work your program, and repeat – forever.”

It’s also difficult to remember that people have been quitting drinking for as long as alcohol has existed. Some individuals quit when their doctor suggests it’s time; others when spouses threaten to leave; a few when they collect their first DUI with all of the attendant costs and embarrassment; and still more just because they decide to. They quit with or without help or programs or meetings.

So, what happened? (more…)

Written by Mary Ellen Barnes, Ph.D.

Click here to contact Mary Ellen and/or see her GoodTherapy.org Profile

It’s a common, if quiet, complaint heard over lunch, or at breaks in meetings, at the Chamber of Commerce mixer, or the League of Women Voters retreat. “My husband finally quit drinking, attends AA, and life is certainly calmer, but…” The “buts” are varied, but essentially come down to the fact that while one’s spouse is no longer actively drinking little else has changed.
An unfortunate side effect of AA and other 12-Step based programs is that while they may help a man stop drinking, they actually encourage him to maintain, and even expand, his focus on alcohol. So he continues to neglect his family and remain emotionally distant from his wife and she doesn’t even get to complain about it because he is “working his program.” For her, precious little has changed.

“I’m truly glad that he isn’t drinking,” one said. “I don’t miss the late night worrying, the calls for bail or a ride home. I don’t miss wondering about our debts, credit rating, or whether he’s going to get fired. But he’s still got his head in a bottle and we don’t even fight anymore. There seems to be so much less of him now than when he was drinking, even. I probably sound selfish and ungrateful, but I miss him.”

It’s a common and heart-breaking story. Another failure of the American system of alcohol treatment - a system that even when it works merely substitutes one form of alcohol obsession for another. (more…)

Written by Edward W. Wilson, Ph.D., MAC

Click here to contact Edward and/or see his GoodTherapy.org Profile

For decades the research, both formal studies and informal observations, has shown that some alcoholics could return to moderate or controlled drinking, and that many do. However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn’t an alcoholic - not matter how obvious the evidence to the contrary.

While their traditional conceptions and definitions have caused the AA/12 Step organizations to reject the mounting evidence, they haven’t been alone. The treatment “industry” also has a vested interest in keeping definitions and solutions narrowly defined and simple. There is, in their lexicon, only one “disease” and one “cure.” Since 95% of providers are wedded to the 12 Step model, and have nothing else to offer, suggestions that other outcomes are possible are very unwelcome. In the United States even those programs describing themselves as “alternatives to the AA/12-Step models” generally adhere to abstinence-only outcome criteria.

But individuals and providers alike would be better served by the different picture painted by an analysis of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Based on a sample of 43,000 U.S. adults, the study found that more than one-third (35.9 percent) of those with alcohol dependence (alcoholism) that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism). (more…)

Written by Mary Ellen Barnes, Ph.D.

Click here to contact Mary Ellen and/or see her GoodTherapy.org Profile

No single idea keeps people from seeking help with their alcohol related problems as much as the mistaken belief that alcohol abuse, dependence, and addiction are always the symptoms of an actual “disease” and that there is only one “cure.” However, just as everyone knows someone who currently has problems with alcohol, we also know someone whose problems seemed to disappear. How can a supposedly life-long, progressive, and fatal disease simply evaporate and not just occasionally, but often enough for remission to be more the rule than the exception?

Clearly something doesn’t add up and, not surprisingly, misleading impressions can be directly traced to the treatment industry’s advertising. Not that it’s totally false, just as self-serving as most ads. Unhappily, the hype has also been so successful that nearly everyone has come to believe it, no matter how much the research and their own experience suggests otherwise.
As is often the case, the reality is more complex than the advertising. There are, of course, people who need to stop drinking permanently and for whom moderation or a return to “social drinking” is impossible. They are much like most ex-smokers. Yet the need to abstain is not the same as being sentenced to a lifetime of meetings, medallions, rituals, and an alcohol focused life. That prescription works for a few, perhaps five to ten percent of those who try it voluntarily, and fewer of those who are coerced into it. (more…)

Written by Lana M. Ackaway, LCSW-R, NCPsyA, CASAC

Click here to contact Lana and/or see her GoodTherapy.org Profile

The chief issue with chemical dependency/addiction is that most often an addict believes he/she can use safely. I’ve never encountered a chemically dependent individual who thinks, feels, says or behaves otherwise. Some never give up on this idea—and as a result, there exists needless deaths—some mentally, some spiritually, and for others, real death. For many, “Intervention” is the only way to save a life. Interventions for substances (alcohol, other drugs and prescription medication) to families and others (employers, associates, friends, etc.) can help break denial with addiction.

The heart of addiction, of course, resonates with human psychological suffering. Human issues of experiencing emotion are in the extreme: feelings are overwhelming and unbearable, or they are absent and confusing. Addiction resonates in an inability to control one’s life. These individuals alternate between losing control of their behavior and substances and then, often at the same time, they exert multiple and varied attempts to gain and maintain control . Drugs (including alcohol) are compelling because they initially work, but ultimately due to physical tolerance and evolving diminished psychological capacities, the attempts at self-correction fail. Suicide often becomes a fatal alternative. (more…)

Written by Edward A. Dreyfus, Ph.D.

Click here to contact Edward and/or see his GoodTherapy.org Profile

I have been alarmed by the increasing incidence of alcohol and drug abuse, especially among teenagers.  Users are getting younger; even children as young as eight years old have been found using various mind-altering substances.  This article will focus on giving you information about the various treatments available for alcohol and substance abuse in the hope that it may help you or someone you know obtain the treatment needed.

Drug, alcohol, and tobacco use is the cause of more deaths, illnesses, and disabilities than any other preventable health condition and seriously undermines America’s family life, economy and public safety1.  For the past few decades, national surveys have consistently shown that about 10 percent of American adults have significant problems related to their own use of alcohol.  In addition, about 25 percent of adults have reported that they use tobacco on a regular basis and about 7 percent use illegal drugs.  The following are some additional alarming statistics: (more…)

Written by Eric Denner, LMFT

It can be very difficult to tell if someone has a problem with drugs or alcohol. In the past addiction was defined primarily by physiological measures: tolerance and withdrawal. In the past few decades the definition has expanded to include:

- taking the substance in larger amounts or over a longer period than intended
- desire or unsuccessful efforts to cut down or control use
- a great deal of time spent in activities necessary to obtain, use, or recover from the effects of a substance
- failure to meet important social, family, or occupational obligations or giving up or reducing recreational activities
- continued use despite adverse consequences
- tolerance
- withdrawal (more…)

Written by Kent Toussaint, MA, LMFT

Click here to contact Kent and/or see his GoodTherapy.org Profile

One day, you go into your son’s room and to your surprise, you find that missing can of whipped cream under his bed.  You think to yourself, “That’s odd.”

Out of your daughter’s backpack falls the can of paint thinner you used three years ago when you remodeled the kitchen and has since been sitting out in the garage among the other discarded tools and supplies.  You then ponder, “Is she in art class this semester?”

If something like this has happened to you, your kid may very well be abusing inhalants.  If he is, he’s in danger of not only destroying his mind and body but he could also die.

What are inhalants?

(more…)