Thursday, May 14, 2015

In community

Ugh... those dang 'shoulds'...

The honest truth is that when you are walking the path of being a parent to a teen struggling with a co-occurring disorder (read more here) - in our case, addiction and a history of severe depression and possibly bipolar, you pretty much want to know anything and everything about how you can help them deal with this situation. The other side of the coin is that you yourself need help dealing with situation, as well as any family member living under the same roof. It is a very tough situation. It has been my experience that helpful information is at best inconsistent, not readily available, and often contradictory.

I am particularly interested in how we can help people return to us once they've opened the Pandora's Box of addiction. Pretty much all of the past research I have done has either been along the Al-Anon approach, which states you need to be harsh in order to be kind, and should tell them that if they are unable to follow your rules, they will need to leave, in hopes they may "reach their bottom" and make the choice to turn themselves around. Or, the NAMI approach, which states the addict is dealing with a co-occurring mental illness, and sending them away to "reach their bottom" will likely mean drug use will undoubtably increase, and you may lose them altogether.
Both of these approaches contradict each other. It is incredibly frustrating and difficult to determine the best course of action to take when you are standing at this particular crossroad. I, for one, can tell you I lay awake nights pondering these two scenarios, and fretting about which scenario is the right one to enforce.
So it was with great interest that I came upon this article on understanding addiction, based on the book, Chasing The Scream, by Johann Hari. For once, a solution has been presented to me that makes sense whether you are dealing with straight addiction, or the situation of a person with a co-occurring disorder.

What Mr. Hari endorses in his writings is about taking a more compassionate approach towards the addicts in your life. Instead of turning them out of the family, and shunning the whole of them as a society, the way to evoke true and lasting change is by bringing them back into the communal fold, offer them jobs and life purpose, in short, help them to feel a part of a happy community, and they will have reason enough to stop using drugs, and become involved within their community.

Hari discusses a study by Professor Bruce Alexander, which challenges the idea that addiction is a moral failing caused by too much partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In face, he argues, addiction is an adaptation. "It's not you. It 's your cage." Do you remember the study from the 1970s where they put a rat in a cage and offered it plain water verses cocaine laced water? Invariably, the rat would choose the cocaine water, and use it until it died. The main failing in this study is that the rats were alone in the cage. The rats who used cocaine until they died were isolated and alone.
"The rats with good lives didn't like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did."
If you, like me, are still struggling to find your way through this addiction maze, and you still believe that addiction is caused by chemical hooks in the brain, this new theory throws a monkey wrench into that way of thinking. But, looking at Bruce Alexander's theory puts a different spin on things. Prof. Alexander talks about medical patients who are hospitalized and taking massive quantities of drugs to control pain. Even though the drugs they are taking are the purest form of addictive drugs, these patients can successfully wean themselves off the drugs, and then return home to the environment where they are supported. They do not become addicts.

If you still believe -- as I do (used to?) -- that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander's theory, the picture falls into place. 
The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.
How do we interpret this? 
It seems the opposite of addiction is not sobriety. It is human connection.
Wow. Just wow. 

This makes sense to me. Shunning someone who is struggling, and turning them out often leads them towards hopelessness and, in my opinion, is a recipe for disaster. I understand that people are sometimes faced with no choice BUT to turn them out. When stealing, lying and manipulative behaviors are the norm combined with excessive drug/alcohol use, well, who can live with that? This is the time where boundaries can be used. Telling your loved one that you want to help them, but certain behaviors will not be tolerated in your home is key. 

Please stay tuned.... more on human connection and community, and how I am handling things in my own household coming up in my next post... (You can read the unexpected update here)