Fear and It’s Variations 

September 10, 2017

Look at all the worry you could have wasted getting to this point in dealing with the hurricane. 
Worry is fear of being afraid. Anxiety is fear of being afraid. 

Fear is a signal that there might be a threat and we should check out. 

If there is a threat, the fear converts into either anger (to fight), fear (to run), or ambivalence ( to hunker down and shelter in place). Anxiety and fear are friends because they alert us to potential danger. Worry is a impotent waste because it focus us upon a fog of immobility. 


Old vs. Young 

September 10, 2017

Checking out at the store, the young cashier suggested to the much older lady that she should bring her own grocery bags, because plastic bags are not good for the environment.The woman apologized to the young girl and explained, “We didn’t have this ‘green thing’ back in my earlier days.”

The young clerk responded, “That’s our problem today. Your generation did not care enough to save our environment for future generations.”

The older lady said that she was right — our generation didn’t have the “green thing” in its day. The older lady went on to explain:

Back then, we returned milk bottles, soda bottles and beer bottles to the store. The store sent them back to the plant to be washed and sterilized and refilled, so it could use the same bottles over and over. So they really were recycled. But we didn’t have the “green thing” back in our day.

Grocery stores bagged our groceries in brown paper bags that we reused for numerous things. Most memorable besides household garbage bags was the use of brown paper bags as book covers for our school books. This was to ensure that public property (the books provided for our use by the school) was not defaced by our scribblings. Then we were able to personalize our books on the brown paper bags. But, too bad we didn’t do the “green thing” back then.

We walked up stairs because we didn’t have an escalator in every store and office building. We walked to the grocery store and didn’t climb into a 300-horsepower machine every time we had to go two blocks.

But she was right. We didn’t have the “green thing” in our day.

Back then we washed the baby’s diapers because we didn’t have the throw away kind. We dried clothes on a line, not in an energy-gobbling machine burning up 220 volts. Wind and solar power really did dry our clothes back in our early days. Kids got hand-me-down clothes from their brothers or sisters, not always brand-new clothing.

But that young lady is right; we didn’t have the “green thing” back in our day. 

Back then we had one TV, or radio, in the house — not a TV in every room. And the TV had a small screen the size of a handkerchief (remember them?), not a screen the size of the state of Montana. In the kitchen we blended and stirred by hand because we didn’t have electric machines to do everything for us. When we packaged a fragile item to send in the mail, we used wadded up old newspapers to cushion it, not Styrofoam or plastic bubble wrap. Back then, we didn’t fire up an engine and burn gasoline just to cut the lawn. We used a push mower that ran on human power. We exercised by working so we didn’t need to go to a health club to run on treadmills that operate on electricity.

But she’s right; we didn’t have the “green thing” back then.

We drank from a fountain when we were thirsty instead of using a cup or a plastic bottle every time we had a drink of water. We refilled writing pens with ink instead of buying a new pen, and we replaced the razor blade in a r azor instead of throwing away the whole razor just because the blade got dull.

But we didn’t have the “green thing” back then.

Back then, people took the streetcar or a bus and kids rode their bikes to school or walked instead of turning their moms into a 24-hour taxi service in the family’s $45,000 SUV or van, which cost what a whole house did before the”green thing.” We had one electrical outlet in a room, not an entire bank of sockets to power a dozen appliances. And we didn’t need a computerized gadget to receive a signal beamed from satellites 23,000 miles out in space in order to find the nearest burger joint.

But isn’t it sad the current generation laments how wasteful we old folks were just because we didn’t have the “green thing” back then?

Please forward this on to another selfish old person who needs a lesson in conservation from a smart ass young person.

We don’t like being old in the first place, so it doesn’t take much to piss us off… Especially from a tattooed, multiple pierced smartass who can’t make change without the cash register telling them how much.


MY FINAL POFESSIONAL GOALS

May 21, 2017

By Terence T. Gorski, May 21, 2017

Life goes on! As my life moves into its final chapter, I realize that two great challenges face me:
1. Organizing and archiving in an easily understandable and useable way, the great archive of organized knowledge and useable skills about recovery technology and relapse prevention that I have spent over 45 years of my career developing so it can be readily available for future generations. (I have begun this project at http://www.terrygorski.com); and

2. To set up an ongoing international movement to transmit this RECOVERY AND RELAPSE PREVENTION TECHNOLOGY to the next generations of clinicians. 

3. To motivate them to deeply understand and build upon these principles and practices by integrating it with their personal clinical skills and program styles, so they My continue to improve it based upon based upon their personal experiences and continued completion and application of research. 

As your life goes on, please consider joining me in moving these final challenges of my career forward. If you wish to join me please forward your email to tresa@cenaps.com


How To Develop A Relapse Prevention (RP) Plan

August 7, 2016

By Terence T. Gorski

GORSKI-CENAPS Web Publications www.cenaps.com www.relapse.org

August 8, 3016 (Updated from May 28, 2003)

People who relapse aren’t suddenly taken drunk. Most experience progressive warning signs that reactivate denial and cause so much pain and so many problems that self-medication with alcohol or other drugs (AODS) seems like a good idea. 

 These warning signs are not a consciously created. They develop automatically and unconsciously. 

Since most recovering people have never been taught how to identify and manage relapse warning signs, they don’t notice them until the pain and problems become too severe to ignore. This is often too late. The pain and problems have activated addictive thinking and drug seeking behavior that is difficult to stop. 

The progressive addiction process causes addicts to developed deeply entrenched habits of coping with pain and problems by self-medicating with AODS. They don’t make the decision to self-medicate consciously. They go on automatic pilot and the deeply entrenched habits of addictive thinking and alcohol/drug seeking behavior kick in. 

They focus on “not using” because they mistakenly believe that their addiction lives in the alcohol alcohol and other drugs. If they just make a decision to stop and tough it out through the first few days of sbstinrmce they will feel better and their life will automatically return to normal. In other words, they decide to get sober using will power alone. This is often called “white knuckle sobriety” because it is a painful process of holding onto abstinence  by hanging on with your finger tips 

Unfortunately this doesn’t work. The longer they grit their teeth and force themselves “not to drink or use drugs” the higher their stress gets. High stress increases their pain and problems and wipes out their thinking and problem solving skills. 

The only way most addicts know how to manage pain and solve problems is by self-medicating their distress by using AODS. “Besides,” they tell themselves. “I made a commitment not to drink or use drugs. So I won’t.” A part of them knows that this won’t work. They have been here and done before. “But this time,” they tell themselves, “things will be different.” So they grit their teeth and set their mind on not drinking or drugging. They refuse to change their thinking or how they manage their feelings and behavior. 

In other words, they keep thinking, managing their feelings, acting, and relating to others the same way they did when they were using. The only difference is they stopped using. 

They never learned other ways to manage stress, pain and problems without using. They thought this would just happen automatically when they stopped using. They never considered that addiction does not live in the alcohol or drugs they use. 

Addiction lives in within us and around us in many different ways. Addiction lives the way we think and the way we manage our feelings. It lives in the way we act and how we relate to other people. It lives in the places we go and in the things we do and don’t do. It lives and things we surround ourselves with. Our addiction lives in the addictive values we guide our lives by and the alcohol and drug centered social networks we have built. 

So we keep thinking, feeling, and acting like a drunk or an active drug addict but we stop using. We keep surrounding ourselves with people who drink and use drugs but we stop using. We never consider that we need to learn a new set of sober and responsible life skills and develop a new sobriety-centered lifestyle.

So the stress and pain builds up inside of us. We mismanage our lives and the problems we encounter. We deny how badly things are going and how much pain we are feeling. It doesn’t take long before we are feeling so bad that we ask ourselves “if this is sobriety, who wants it?”

We start to think that at least when we were drinking and drugging we had moments of feeling good and periods of escape from the stress, pain, and problems of life. When not using the pain and problems are always there. 

Things keep getting worse until we hurt so bad we mistakenly believe that we only have three choices: 

  • To keep forcing ourselves to carry on until we collapse from stress or stress-related physical or mental health problems; 
  • To end the pain by committing  suicide,or 
  • To self-medicate with AODS to end the pain. 

If we decide to self-medicate, we convince ourselves that this time it will be different. This time we will control our drinking and drugging better than we did before. Deep inside of us is a sober sand responsible part of ourselves telling us not to do this because it won’t work. 

    The truth is that no matter how bad things get in sobriety there is always another choice we can make. We don’t have to self-medicate with alcohol or other drugs. We can develop a Relapse Prevention (RP) Plan by identifying exactly how we created the pain and problems lea us back into addictive use. Then we can identify where we can stop this process of building up to drink by making a detailed Relapse Prevention (RP) Plan. To be effective this plan must include a clear picture of the sequence of relapse warning signs that leaf us back into addictive use. Three places in this progression where we can stop the process. We can identify new and more effective ways of thinking, feeling, acting, and relating to others that will break this process of building up to drink/drug. We can practice using these relapse prevention skills before we are in a crisis. We can be prepared to interrupt the progression of relapse warning signs so we can stop the process before we start drinking or drugging.  This means that we need to develop a Relapse Prevetion Plan. 

    The Relapse Prevetion Plan

    There are nine steps in learning how to recognize and stop the early warning signs of relapse. Let’s review the nine steps of the RP planning process in more detail. 

     Step 1: Stabilization: 

    Relapse prevention planning probably won’t work unless the relapser is sober and in control of themselves. Detoxification and a few good days of sobriety are needed in order to make relapse prevention planning work. 

    Remember that many people who relapse are toxic. Even though sober they have difficulty thinking clearly, remembering things and managing their feelings and emotions. These symptoms get worse when the person is under high stress or is isolated from people to talk to about the problems of staying sober. 

    This is not the time to do intense psychotherapy that digs up painful memories from childhood. This will come latter in recovery when the relapse  solid recovery and relapse prevention plan that gives them the skills and support they need to stay sober one day at a time.  Many relapsers are late stage addicts and have a toxic brain that can increase rather than decrease the risk of relapse. In early abstinence it is important to go slowly and focus on basic recovery skills The key question is “What do you need to do to not drink today?”

     Step 2: Assessment: 

    The assessment process is designed to identify the recurrent pattern of problems that caused past relapses and resolve the pain associated with those problems. 

    This is accomplished by writing down the presenting problems and how those problems are related to their addiction. It also involves guiding the person through a life history, the alcohol and drug use history and the recovery relapse history.

     By reconstructing the presenting problems the here and now issues that pose an immediate threat to sobriety can be identified and crisis plans developed to resolve those issues.

     The life history explores each developmental life period including childhood, grammar school, high school, college, military, adult work history, adult friendship history, and adult intimate relationship history. Reviewing the life history can surface painful unresolved memories. It’s important to go slow and talk about the feelings that accompany these memories.

    Once the life history is reviewed, a detailed alcohol and drug use history is reconstructed. This is be done by reviewing each life period and asking four questions: 

    1. How much alcohol or drugs did you use during this life period?  

    2. How often did you use during this life period? 

    3. What did you want alcohol and drug use to do for you that you couldn’t do without it? and 

    4. What were the real consequences, both positive and negative, of your use? In other words, did the booze and drugs do for you what you wanted it to do during each period of your life?

    Finally, the recovery and relapse history is reconstructed. Starting with the first serious attempt at sobriety each period of abstinence and AOC use is carefully explored. 

    The goal is to find out what happened during each period of abstinence that set the stage for renewed AOD use. This is often difficult because most relapsers are preoccupied with their drinking and drugging and resist thinking or talking about what happened during periods of abstinence. Some people use euphoric recall to romanticize their use. They lock onto and exagerrate the good times of an episode of AOD use and blocking out the pain and the problems. 

    Comprehensive assessments have shown that most relapsers get sober, encounter the same recurring pattern of problems, and use those problems to justify the next relapse. As one person put it “It is not one thing after the other, it is the same thing over and over again!”

     A 23 year old relapser named Jake reported drinking about a six pack of beer every Friday and Saturday night during high school. He did it in order to feel like he was part of the group, relax and have fun. At that stage in his addiction the beer did exactly what he wanted it to do.

     That all changed when Jake left school and went to work as a salesman. He had to perform in a high pressure environment and felt stressed. The other salesmen were competitive and no matter what he did they wouldn’t let him belong. He began drinking bourbon every night to deal with the stress. He wanted to feel relaxed so he could cope better at work. He consistently drank too much and woke up with terrible hangovers that caused new problems with his job.

     Every time Jake would attempt to stop drinking he would feel isolated and alone and become overwhelmed by the stress of his job. Even when with others at Twelve Step Meetings he felt like he didn’t belong and couldn’t fit in. As the stress grew he began to think “If this is sobriety who needs it?” Each relapse was related with his inability to deal with job related pressures.

     By comparing the life history, the alcohol and drug use history, and the recovery relapse history Jake could see in a dramatic way the recurrent problems that caused him to relapse. The two major issues were (1) the need to drink in order to feel like he belonged and (2) the need to drink in order to cope with stress.

     It wasn’t surprising that Jake discovered that during every past period of abstinence he became isolated, lonely and depressed. The longer he stayed sober the worse it got. The stress built up until he felt that if he didn’t take a drink to relax he would go crazy or collapse.

    Step 3: Relapse Education: 

     Relapsers need to learn about the relapse process and how to manage it. It’s not a bad idea to get their family and Twelve Step Sponsors involved. The education needs to reinforce four major messages: First, relapse is a normal and natural part of recovery from chemical dependence. There is nothing to be ashamed or embarrassed about. Second, people are not suddenly taken drunk. There a progressive patterns of warning signs that set them up to use again. These warning signs can be identified and recognized while sober. Third, once identified recovering people can learn to manage the relapse warning signs while sober. And Fourth, there is hope. A new counseling procedure called relapse prevention therapy can teach recovering people how to recognize and manage warning signs so a return to chemical use becomes unnecessary.

     When Jake entered relapse prevention therapy he felt demoralized and hopeless. That began to change when he heard his first lecture that described the typical warning signs that precede relapse to chemical use. He felt like someone had read his mail. “Since someone understand what causes me to get drunk,” he thought, “perhaps they know what to do in order to stay sober.

     Step 4: Warning Sign Identification: 

    Relapsers need to identify the problems that caused relapse. The goal is to write a list of personal warning signs that lead them from stable recovery back to chemical use.

     There is seldom just one warning sign. Usually a series of warning signs build one on the other to create relapse. It’s the cumulative affect that wears them down. The final warning sign is simply the straw that breaks the camel’s back. Unfortunately many of relapsers think it’s the last warning sign that did it. As a result they don’t look for the earlier and more subtle warning signs that set the stage for the final disaster.

      When Jake first came into relapse prevention therapy he thought that he was crazy. “I can’t understand it,” he told his counselor, “Everything was going fine and suddenly, for no reason at all I started to overreact to things. I’d get confused, make stupid mistakes and then not know what to do to fix it. I got so stressed out that I got drunk over it.”

     Jake, like most relapsers, didn’t know what his early relapse warning signs were and as a result didn’t recognize the problems until it was too late. A number of procedures are used to help recovering people identify the early warning signs relapse.

     Most people start by reviewing and discussing The Phases And Warning Signs Of Relapse (available from Independence Press, PO Box HE, Independence MO 64055, 1-800-767-8181). This warning sign list describes the typical sequence of problems that lead from stable recovery to alcohol and drug use. By reading and discussing these warning signs relapsers develop a new way of thinking about the things that happened during past periods of abstinence that set them up to use. They learn new words with which to describe their past experiences.

     After reading the warning signs they develop an initial warning sign list by selecting five of the warning signs that they can identify with. These warning signs become a starting point for warning sign analysis. Since most relapsers don’t know what their warning signs are they need to be guided through a process that will uncover them. The relapser is asked to take each of the five warning signs and tell a story about a time when they experienced that warning sign in the past while sober. They tell these stories both to their therapist and to their therapy group. The goal is to look for hidden warning signs that are reflected in the story.

     Jake, for example, identified with the warning sign “Tendency toward loneliness.” He told a story about a time when he was sober and all alone in the house because his wife had left with the children. “I felt so lonely and abandoned, he said. I couldn’t understand why she would walk out just because we had a fight. She should be able to handle it better than she does.”

     The group began asking questions and it turned out that Jake had frequent arguments with his wife that were caused by his grouchiness because of problems on the job. It turned out that these family arguments were a critical warning sign that occurred before most relapses. Jake had never considered his marriage to be a problem, and as a result never thought of getting marriage counseling. 

     Jake had now identified three warning signs: (1) the need to drink in order to feel like he belonged, (2) the need to drink in order to cope with stress, and (3) the need to drink in order to cope with marital problems. In order to be effectively managed each of these warning would need to be further clarified.

     I then had Jake to write these three warning signs using a standard format and identify the irrational thoughts, unmanageable feelings and self defeating behavior that accompanied each. He wrote: 

    (1) I know I am in trouble with my recovery when I feeling lonely and unable to fit in with other people; When this happens I tend to think that I am no good and nobody could ever care about me. When this happens I tend to feel lonely, angry and afraid. When this happens I have an urge to hide myself away so I don’t have to talk with anyone.  

    (2) I know I am in trouble with my recovery when I feel unable to cope with high levels of job-related stress; When this happens I tend to think that I need to try harder in order to get things under control or else I will be a failure. When this happens I tend to feel humiliated and embarrassed. When this happens I drive myself to keep working even thought I know I need to rest.

    (3) I know I am in trouble with my recovery when I irrationally angry at my wife. When this happens I tend to think that I’m a terrible person for treating her that way, but a part of me believes she deserves it. When this I happens I tend to feel angry and ashamed. When this happens forget that the incident ever happened, put it behind us and get on with our marriage.  

    With this detailed description of the relapse warning signs Jake was ready to move on to the fifth step of relapse prevention planning, warning sign management.  

    Understanding the warning signs is not enough. We need to learn how to manage them without resorting to alcohol or drug use. This means learning nonchemical problem solving strategies that help us to identify high risk situations and develop coping strategies. In this way relapsers can diffuse irrational thinking, manage painful feelings, and stop the self-defeating behaviors before they lead to alcohol or drug use.

     This is done by taking each relapse warning sign and developing a general coping strategy. Jake, for example developed the following management strategy for dealing with his job related stress.

    Warning Sign: I know I am in trouble with my recovery when I feel unable to cope with high levels of job-related stress.

    General Coping Strategy: I will learn how to say no to taking on extra projects, limit my work to 45 hours per week, and learn how to use relaxation exercises and meditation to unwind.

     The next step is to identify ways to cope with the irrational thoughts, unmanageable feelings, and self-defeating behaviors that accompany each warning sign. Jake developed the following coping strategies:

    Irrational Thought: I need to try harder in order to get things under control or else I will be a failure.

    Rational Thought: I am burned out because I am trying to hard. I need to time to rest or I will start making more mistakes.

    Unmanageable Feelings: Humiliation and embarrassment.

    Feeling Management Strategy: Talk about my feelings with others. Remind myself that there is no reason to embarrassed. I am a fallible human being and all people get tired.

    Self-defeating Behavior: Driving myself to keep working even thought I know I need to rest.

    Constructive Behavior: Take a break and relax. Ask someone to review the project and see if they can help me to solve the problem.

     Now Jake is ready to move unto the sixth step of recovery planning. A recovery plan is a schedule of activities that puts relapsers into regular contact with people who will help them to avoid alcohol and drug use. They must stay sober by working the twelve step program and attending relapse prevention support groups that teach them to recognize and manage relapse warning signs. This is why I call relapse prevention planning a “Twelve Step Plus” approach to recovery.

     Jake needed to build something into his recovery program to help him deal with job related stress. He decided to enter into counseling with a counselor who specialized in stress management, understood chemical dependency and had a background as an employee assistance counselor. By doing this Jake was forced to regular discuss his problems at work and review how he was coping with them. By identifying job related problems early, he could prevent getting overwhelmed by small problems that became overwhelming.

     The seventh step is inventory training. Most relapsers find it helpful to get in the habit of doing a morning and evening inventory. The goal of the morning inventory is to prepare to recognize and manage warning signs. The goal of the evening inventory is to review progress and problems. This allows relapsers to stay anticipate high risk situations and monitor for relapse warning signs. Relapsers need to take inventory work seriously because most warning signs are deeply entrenched habits that are hard to change and tend to automatically come back whenever certain problems or stresses occur. If we aren’t alert we may not notice them until it’s too late.

     The eighth step is family involvement. A supportive family can make the difference between recovery and relapse. We need to encourage our family members to get involved in Alanon so they can recover from codependency. With this foundation of shared recovery we can beginning talking with our families about past relapses, the warning signs that led up to them, and how the relapse hurt the family. Most importantly we can work together to avoid future relapse.

     If we had heart disease we would want our family to be prepared for an emergency. Chemical dependency is a disease just like heart disease. Our families’ needs to know about the early warning signs that lead to relapse. They must be prepared to take fast and decisive action if we return to chemical use. We can work out in advance, when we are in a sober state of mind, the steps they should take if we return to chemical use. Our very life could depend upon it.

     The final step is follow-up. Our warning signs will change as we progress in recovery. Each stage of recovery has unique warning signs. Our ability to deal with the warning signs of one stage of recovery doesn’t guarantee that we will recognize or know how to manage the warning signs of the next stage. Our relapse prevention plan needs to be updated regularly; monthly for the first three months, quarterly for the first two years, and annually thereafter.

     

    Originally Published In: Alcoholism & Addiction Magazine: Relapse – Issues and Answers: Column 3: How To Develop A Relapse Prevention Plan: By Terence T. Gorski, September 25, 1989; 708-799-5000, http://www.cenaps.com.

    CENREF ART003

    About the Author

    Terence T. Gorski is internationally recognized for his contributions to Relapse Prevention Therapy. The scope of his work, however, extends far beyond this. A skilled cognitive behavioral therapist with extensive training in experiential therapies, Gorski has broad-based experience and expertise in the chemical dependency, behavioral health, and criminal justice fields.
    To make his ideas and methods more available, Gorski opened The CENAPS Corporation, a private training and consultation firm of founded in 1982. CENAPS is committed to providing the most advanced training and consultation in the chemical dependency and behavioral health fields.
    Gorski has also developed skills training workshops and a series of low-cost book, workbooks, pamphlets, audio and videotapes. He also works with a team of trainers and consultants who can assist individuals and programs to utilize his ideas and methods.

    Terry Gorski is available for personal and program consultation, lecturing, and clinical skills training workshops. He also routinely schedules workshops, executive briefings, and personal growth experiences for clinicians, program managers, and policymakers.

    ——–

    Mr. Gorski holds a B.A. degree in psychology and sociology from Northeastern Illinois University and an M.A. degree from Webster’s College in St. Louis, Missouri. He is a Senior Certified Addiction Counselor In Illinois. He is a prolific author who has published numerous books, pamphlets and articles. Mr. Gorski routinely makes himself available for interviews, public presentations, and consultant. He has presented lectures and conducted workshops in the U.S., Canada, and Europe.  

    For books, audio, and video tapes written and recommended by Terry Gorski contact: Herald House – Independence Press, P.O. Box 390 Independence, MO 64055. Telephone: 816-521-3015 0r 1-800-767-8181. His publication website is http://www.relapse.org.

    Terry Gorski and other members of the GORSKI-CENAPS Team are available to train & consult on areas related to recovery & relapse prevention 


    Defining Yourself as an Adult

    July 31, 2016

    Choose Carefully How You Define Yourself As An Adult

    All social roles are in transition, temporarily trapped in a dynamic tension between the old world view of adulthood which views the adult as a finished being who has stopped growing and merely transmitted what has already been learned and experienced to the next generation.

    The new world view is adults continue to grow throughout the course if their life span right up until the moment of death if they have the right mind-set to adapt, survive, and learn from life’s experience. 

    Mature adults learn from all people, including children and fools. They are intrigued by the complexity of the human mind and human behavior. They are constantly poking at life — doing controlled experiments, if you will, in the laboratory of life. 

    In this paradigm (belief system) an adult is a living growing organism building a complex view of the world based upon the progressive integrations of stages, levels, and experiences of life.
    Henry Miller, in his book The Tropic of Capricorn describes the old paradigm of adulthood in this way: “Once you become an adult, you lose your personhood and transform into a frightened and calculating being. I’ve watched sadly as my friends grew up and stopped being real, stopped being persons.”

    “At seven years, we knew with dead certainty … that such a fellow would end up in prison, that another would be a drudge, and another a good for nothing, and so on. We were absolutely correct in our diagnoses, much more correct … than our parents or our teachers — more correct, indeed, than the so-called psychologists. The academic learning we received only tended to obscure our vision of a mature adult. From the day we went to school, we learned nothing; on the contrary, we were made obtuse, we were wrapped in a fog of words and abstractions.”

    I can build upon the thinking of Henry Miller by saying that as adults became separated from the experience of life when they get trapped in the idea of what a life could or should be. 

    In other words, we were taught to live according to the thinking of others and ignore our own mind and unique intuitions — to shut down the guilt inner voice whispering to us and only to us what our true purpose in life, are true destiny, really is. Instead we were socialized to belong and become a cog in the machinery of culture and society.

    “What I am thinking of, with a certain amount of regret and longing, is that this thoroughly restricted life of early boyhood seems like a limitless universe, and the life that followed upon it, the life of an adult, a constantly diminishing realm. From the moment when one is put in school one is lost, one has a feeling of having a halter put around his neck. The taste goes out of the bread as it goes out of life. Getting the bread becomes more important than the eating of it. Everything is calculated, and everything has a price on it.”

    Peter Pan told us that we should never become grownups, never become adults. He said that we should just stay children — remain trapped in childhood. 

    Timothy Leary — famous for his bumper sticker saying: “Turn on, tuner, in, and drop out.” — made the use of the psychedelic drug LSD an extension of his philosophy of adulthood as an endless childhood in which we he kept randomly learning and growing through relatively unpredictable expansions in consciousness that could never be fully understood. 

    In reading his autobiography, Flashback by Timothy Leary, it is obvious that this approach to adulthood gave him intense experiences while allowing him to be manipulated and used by powerful forces beyond his control and never really getting the big picture of life and living.

    Timothy Leary has been quoted by Eugene Marks as saying that the word adult is the past participle of the Latin verb “adulescere,” meaning to have grown up or to have already lived one’s life. He advised people to “never let yourself become a past participle, Which means that you have already lived your life and are now done living and merely transmit culture.”

    Eugene Marks expressed his personal experience with the new paradigm of adulthood as an ongoing process of deliberate spiritual, psychological, and social growth in the following:

     “In my life, I have continued to live as I lived as a boy. I am the same person I have always been. I have not left behind the honesty and awareness of my childhood. I have not finished growing. and I have not and never will become one of those uptight and frightened adults.  I don’t see myself as old. I’m still me, still the same person I’ve always been, just older than I was before And I must say, I’m proud of the seventy-eight trips around the sun that I’ve made so far. It’s been quite a ride, and I’m not done yet.” 

    I, personally must add to this description, for I find the description of Eugene Marks as limited — catching the sprit of the thing but leaving out what I have found to be vital details. 

    In my sixty seven years (I was born on March 6, 1949) I have become weathered by the storm of life, mellowed and humble by the winning of battles that had less meaning than I thought they would have, and loosing the battles that hurt me more deeply than I ever believed that they could. I have been injured and healed, covered with scars. I have walked with purpose making the world shake beneath my feet. I have crawled in pain needing others to care for me. I have been lost in the maze. I experienced joy and passion and the depths of depression. In knowing I could take my life, and nearly doing so, I found I could keep my life and transform it.

    I have found myself to be part of the flow of history because I live with a keen awareness that we all stand on the shoulders of those who have come before, and we lift the young upon our shoulders so they should see freedom and in that freedom a better life and more options of thought and experience than we have had available to us. ~ Terry Gorski, January 17, 2012

    **Source:** Adapted from: The Caldron, Actually Its most Adults Who Are Persons by Eugene Marks: http://thecaldron.com/2011/10/actually-its-most-adults-who-are-persons/

    Other resources: For the ancient Chinese, the caldron was a spiritual vessel, a container of light and wisdom. (See the I Ching, Hexagram 50.)

    The Caldron is also a spiritual vessel, a source for light and wisdom.

    Light is indeed needed today, as the world as we know it begins to fall apart, as the darkness grows. 

    A caldron, in military or warrior terminology, is an intense and dangerous test of ability that transforms a person psychologically and spiritually.

    For previous issues of The Caldron see the E-Zine Archives. For my here and now thoughts, see Notes from the Edge. For The Life and Death of Wanderer, see the Weekly Reader.

    You may first wish to read The Birth of Wanderer, the first Wanderer book, the story of one man’s spiritual journey towards wholeness of being. You may access this book with the drop down menu under Birth of Wanderer.

    Welcome and enjoy.

    http://thecaldron.com/ 


    Post Incarceration Syndrome (PICS) and Relapse

    July 29, 2016

    By Terence T. GorskiThe Post Incarceration Syndrome (PICS) is a serious problem that contributes to relapse in addicted and mentally ill offenders who are released from correctional institutions. Currently 60% of prisoners have been in prison before and there is growing evidence that the Post Incarceration Syndrome (PICS) is a contributing factor to this high rate of recidivism. [i]
    The concept of a post incarceration syndrome (PICS) has emerged from clinical consultation work with criminal justice system rehabilitation programs working with currently incarcerated prisoners and with addiction treatment programs and community mental health centers working with recently released prisoners.

    This article will provide an operational definition of the Post Incarceration Syndrome (PICS), describe the common symptoms, recommend approaches to diagnosis and treatment, explore the implications of this serious new syndrome for community safety, and discuss the need for political action to reduce the number of prisoners and assure more humane treatment within our prisons, jails, and correctional institutions as a means of prevention. It is my hope that this initial formulation of a PICS Syndrome will encourage researchers to develop objective testing tools and formal studies to add to our understanding of the problems encountered by released inmates that influence recovery and relapse.

    Post Incarceration Syndrome (PICS) – Operational Definition

    The Post Incarceration Syndrome (PICS) is a set of symptoms that are present in many currently incarcerated and recently released prisoners that are caused by being subjected to prolonged incarceration in environments of punishment with few opportunities for education, job training, or rehabilitation. The symptoms are most severe in prisoners subjected to prolonged solitary confinement and severe institutional abuse.

    The severity of symptoms is related to the level of coping skills prior to incarceration, the length of incarceration, the restrictiveness of the incarceration environment, the number and severity of institutional episodes of abuse, the number and duration of episodes of solitary confinement, and the degree of involvement in educational, vocational, and rehabilitation programs.

    The Post Incarceration Syndrome (PICS) is a mixed mental disorders with four clusters of symptoms:

    (1) Institutionalized Personality Traits resulting from the common deprivations of incarceration, a chronic state of learned helplessness in the face of prison authorities, and antisocial defenses in dealing with a predatory inmate milieu,

    (2) Post Traumatic Stress Disorder (PTSD) from both pre-incarceration trauma and trauma experienced within the institution,

    (3) Antisocial Personality Traits (ASPT) developed as a coping response to institutional abuse and a predatory prisoner milieu, and

    (4) Social-Sensory Deprivation Syndrome caused by prolonged exposure to solitary confinement that radically restricts social contact and sensory stimulation. 

    (5) Substance Use Disorders caused by the use of alcohol and other drugs to manage or escape the PICS symptoms.

    PICS often coexists with substance use disorders and a variety of affective and personality disorders.

    Symptoms of the Post Incarceration Syndrome (PICS)

    Below is a more detailed description of four clusters of symptoms of Post Incarceration Syndrome (PICS):

    1. Institutionalized Personality Traits

    Institutionalized Personality Traits are caused by living in an oppressive environment that demands: passive compliance to the demands of authority figures, passive acceptance of severely restricted acts of daily living, the repression of personal lifestyle preferences, the elimination of critical thinking and individual decision making, and internalized acceptance of severe restrictions on the honest self-expression thoughts and feelings.

    2. Post Traumatic Stress Disorder (PTSD)

    Post Traumatic Stress Disorder (PTSD) [ii] is caused by both traumatic experiences before incarceration and institutional abuse during incarceration that includes the six clusters of symptoms: (1) intrusive memories and flashbacks to episodes of severe institutional abuse; (2) intense psychological distress and physiological reactivity when exposed to cues triggering memories of the institutional abuse; (3) episodes of dissociation, emotional numbing, and restricted affect; (4) chronic problems with mental functioning that include irritability, outbursts of anger, difficulty concentrating, sleep disturbances, and an exaggerated startle response. (5) persistent avoidance of anything that would trigger memories of the traumatic events; (6) hypervigilance, generalized paranoia, and reduced capacity to trust caused by constant fear of abuse from both correctional staff and other inmates that can be generalized to others after release.,

    3. Antisocial Personality Traits

    Antisocial Personality Traits [iii] [iv] [v]are developed both from preexisting symptoms and symptoms developed during incarceration as an institutional coping skill and psychological defense mechanism. The primary antisocial personality traits involve the tendency to challenge authority, break rules, and victimize others. In patients with PICS these tendencies are veiled by the passive aggressive style that is part of the institutionalized personality. Patients with PICS tend to be duplicitous, acting in a compliant and passive aggressive manner with therapists and other perceived authority figures while being capable of direct threatening and aggressive behavior when alone with peers outside of the perceived control of those in authority. This is a direct result of the internalized coping behavior required to survive in a harshly punitive correctional institution that has two set of survival rules: passive aggression with the guards, and actively aggressive with predatory inmates.

    4. Social-Sensory Deprivation Syndrome:

    The Social-Sensory Deprivation Syndrome [vi] is caused by the effects of prolonged solitary confinement that imposes both social isolation and sensory deprivation. These symptoms include severe chronic headaches, developmental regression, impaired impulse control, dissociation, inability to concentrate, repressed rage, inability to control primitive drives and instincts, inability to plan beyond the moment, inability to anticipate logical consequences of behavior, out of control obsessive thinking, and borderline personality traits. 

    5. Reactive Substance Use Disorders

    Many inmates who experience PICS suffer from the symptoms of substance use disorders [vii]. Many of these inmates were addicted prior to incarceration, did not receive treatment during their imprisonment, and continued their addiction by securing drugs on the prison black market. Others developed their addiction in prison in an effort to cope with the PICS symptoms and the conditions causing them. Others relapse to substance abuse or develop substance use disorders as a result of using alcohol or other drugs in an effort to cope with PICS symptoms upon release from prison.

    PICS Symptoms Severity

    The syndrome is most severe in prisoners incarcerated for longer than one year in a punishment oriented environment, who have experienced multiple episodes of institutional abuse, who have had little or no access to education, vocational training, or rehabilitation, who have been subjected to 30 days or longer in solitary confinement, and who have experienced frequent and severe episodes of trauma as a result of institutional abuse. 

    The syndrome is least severe in prisoners incarcerated for shorter periods of time in rehabilitation oriented programs, who have reasonable access to educational and vocational training, and who have not been subjected to solitary confinement, and who have not experienced frequent or severe episodes of institutional abuse.

    Reasons To Be Concerned About PICS

    There is good reason to be concerned because about 40% of the total incarcerated population (currently 700,000 prisoners and growing) are released each year. The number of prisoners being deprived of rehabilitation services, experiencing severely restrictive daily routines, being held in solitary confinement for prolonged periods of time, or being abused by other inmates or correctional staff is increasing. [viii]

    The effect of releasing this number of prisoners with psychiatric damage from prolonged incarceration can have a number of devastating impacts upon American society including the further devastation of inner city communities and the destabilization of blue-collar and middle class districts unable to reabsorb returning prisoners who are less likely to get jobs, more likely to commit crimes, more likely to disrupt families. This could turn many currently struggling lower middle class areas into slums. [ix]

    As more prisoners are returned to the community, behavioral health providers can expect to see increases in patients admitted with the Post Incarceration Syndrome and related substance use, mental, and personality disorders. The national network of Community Mental health and Addiction treatment Programs need to begin now to prepare their staff to identify and provide appropriate treatment for this new type of client.

    The nation’s treatment providers, especially addiction treatment programs and community mental health centers, are already experiencing a growing number of clients experiencing the Post Incarceration Syndrome (PICS). This increase is due to a number of factors including: the increasing size of the prisoner population, the increasing use of restrictive and punishing institutional practices, the reduction of access to education, vocational training, and rehabilitation programs; the increasing use of solitary confinement and the growing number of maximum security and super-max type prison and jails. 

    Both the number of clients suffering from PICS and the average severity of symptoms is expected to increase over the next decade. In 1995 there were 463,284 prisoners released back to the community. Based upon conservative projections in the growth of the prisoner population it is projected that in the year 2000 there will be 660,000 prisoners returned to the community, in the year 2005 there will 887,000 prisoners returned to the community, and in the year 2010 1.2 million prisoners will be released. [x] The prediction of greater symptom severity is based upon the growing trend toward longer periods of incarceration, more restrictive and punitive conditions in correctional institutions, decreasing access to education, vocational training, and rehabilitation, and the increasing use solitary confinement as a tool for reducing the cost of prisoner management.

    Clients with PICS are at a high risk for developing substance dependence, relapsing to substance use if they were previously addicted, relapsing to active mental illness if they were previously mentally ill, and returning to a life of aggression, violence, and crime. They are also at high risk of chronic unemployment and homelessness.

    Post Release Symptom Progression

    This is because released prisoners experiencing PICS tend to experience a six stage post release symptom progression leading to recidivism and often are not qualified for social benefits needed to secure addiction, mental health, and occupation training services. 

    · Stage 1 of this Post Release Syndrome is marked by Helplessness and hopelessness due to inability to develop a plan for community reentry, often complicated by the inability to secure funding for treatment or job training; 

    · Stage 2 is marked by an intense immobilizing fear; 

    · Stage 3 is marked by the emergence of intense free-floating anger and rage and the emergence of flashbacks and other symptoms of PTSD; 

    · Stage 4 is marked by a tendency toward impulse violence upon minimal provocation; 

    · Stage 5 is marked by an effort to avoid violence by severe isolation to avoid the triggers of violence; 

    · Stage 6 is marked by the intensification of flashbacks, nightmares, sleep impairments, and impulse control problems caused by self-imposed isolation. This leads to acting out behaviors, aggression, violence, and crime, which in turn sets the stages for arrest and incarceration.

    Currently 60% of prisoners have been in prison before and there is growing evidence that the Post Incarceration Syndrome (PICS) is a contributing factor to this high rate of recidivism.

    Reducing The Incidence Of PICS

    Since PICS is created by criminal justice system policy and programming in our well intentioned but misguided attempt to stop crime, the epidemic can be prevented and public safety protected by changing the public policies that call for incarcerating more people, for longer periods of time, for less severe offenses, in more punitive environments that emphasize the use of solitary confinement, that eliminate or severely restrict prisoner access to educational, vocational, and rehabilitation programs while incarcerated. 

    The political antidote for PICS is to implement public policies that: 

    (1) Fund the training and expansion of community based addiction and mental health programs staffed by professionals trained to meet the needs of criminal justice system clients diverted into treatment by court programs and released back to the community after incarceration; 

    (2) Expand the role of drug and mental health courts that promote treatment alternatives to incarceration;

    (3) Convert 80% of our federal, state, and county correctional facilities into rehabilitation programs with daily involvement in educational, vocational, and rehabilitation programs; 

    (4) Eliminate required long mandated minimum sentences; 

    (5) Institute universal prerelease programs for all offenders with the goal of preparing them to transition into community based addiction and mental health programs;

    (6) Assuring that all released prisoners have access to publicly funded programs for addiction and mental health treatment upon release.

    [i] Ditton, Paula M. Mental Health and Treatment of Inmates and Probationers, Bureau of Justice Statistics, July 11, 1999 (NCJ-174463), (http://www.ojp.usdoj.gov/bjs/)

    [ii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 424 – 429)

    [iii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 645 – 650)

    [iv] Forrest, Gary G., Chemical Dependency and antisocial Personality Disorder – Psychotherapy and Assessment Strategies, The Hawthorn Press, New York, April 1994

    [v] Hempphill, James F.; Templeman, Ron; Wong, Stephen; and Hare, Robert D. Psychopathy and Crime: Recidivism and Criminal Careers. IN: Cooke, David J.; Forth, Adelle E., and Hare, Robert D. ED: Psychopathy: Theory, Research, and implications for Society, Kluwar Academic Publishers, Boston, 1995

    [vi] Grassian, Stuart, Psychopathological effects of solitary confinement, American Journal of Psychiatry, 140, 1450 – 1454 (1983)]

    [vii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 175 – 272)

    [viii] Ditton, Paula M. Mental Health and Treatment of Inmates and Probationers, Bureau of Justice Statistics, July 11, 1999 (NCJ-174463), (http://www.ojp.usdoj.gov/bjs/)

    [ix] Sabol, William, Urban Institute, Washington DC

    [x] Abramsky, Sasha, When They Get Out, Atlantic Monthly, June, 1999 p. 30


    Spirituality In Recovery 

    July 25, 2016


    By Terence T. Gorski
    GORSKI-CENAPS Web Publications 

    (www.relapse.org)

    May 6, 2001

    Defining Spirituality
    There is a relationship between spirituality and relapse. To understand it, we must first define spirituality. People have both physical characteristics, determined by the structure and actions of their bodies, and non-physical characteristics, determined by the structure and actions of their minds. These non-physical or spiritual characteristics include the ability to perceive, think, feel, act, and assign meaning and purpose to life. 

    Human beings not only think and feel, but they are conscious of the fact that they do so. This individual consciousness creates a core personal identity that moves beyond physical existence into a complex world of ideas and images. This personal consciousness drives people to find meaning and purpose in human existence.

    This desire for a sense of meaning that transcends the physical has led many recovering people to a search for the laws or organizing principles of the non-physical dimension of human existence. They believe that human existence is ruled by laws, or organizing principles. The physical world is governed by physical laws. The non-physical world is governed by mental and spiritual laws. People who live in accordance with these universal laws find peace and serenity in life. They discover a sense of meaning and purpose in their sobriety. Those who violate these universal principles, either through ignorance or intent, experience inner pain, turmoil, and frustration. They become disillusioned in recovery and many relapse to chemical use to medicate the pain.

    Mystical & Non-mystical Spirituality

    There are two different ways of thinking about human spirituality. Mystical spirituality is based upon the belief that there is a spiritual world inhabited by a Higher Power or God. The meaning and purpose of life, according to mystical spirituality, can only be found through a conscious relationship with this spiritual Higher Power who reveals information not available through our ordinary senses or intelligence. The ultimate goal of mystical spirituality, therefore, is to establish a personal relationship with God, and to seek knowledge of his will and the courage to carry that out.

    Non-mystical spirituality recognizes that human beings exist not only in the physical world, but also in a unique world of ideas, thoughts, feelings, and fantasies that transcends physical limitations. In this sense the word spiritual can be used interchangeably with the word psychological. Non-mystical spirituality, like psychology, is directed at learning to effectively use human mental powers to find meaning and purpose in life. The spiritual life is based upon developing these mental and emotional abilities. Non-mystical spirituality, however, believes that human beings can discover basic spiritual truths thorough the use of their senses and intellect. They do not rely upon divine revelation, but look to human reason to find the answers to sobriety.

    Mystical and non-mystical spirituality are not mutually exclusive. 

    Many recovering people have a mixed spiritual system. In the mystical sense, they seek to develop a personal relationship with the God of their understanding and pray to discover what God’s will is for them. In a non-mystical sense, they actively work at psychological growth. They believe this mixture of the mystical and non-mystical captures the principle of “turning it over, but doing the leg work”. Mystical spirituality allows them to turn over some aspects of their human experience to the care of a Higher Power. Non-mystical spirituality allows them to “do the leg work” by taking responsibility for personal growth and change.

    Relapse & The Extremes of Mystical Spirituality

    Extreme and rigid views of spirituality can result in relapse. Many people relapse because they believe that the mystical god of their understanding will somehow magically save them from their problems. They abdicate personal responsibility and expect God to take care of everything. When God doesn’t, they sink into a deep existential depression and say, “Since God won’t fix my life, I might as well get drunk.”

    An example of this is the man who turned $60,000 worth of debt incurred from his cocaine addiction over to his higher power. He was absolutely shocked when his higher power turned his debts over to a collection agency. 

    Another man, who was divorced shortly after getting sober, looked to God to clean up his apartment. He was disappointed when God wouldn’t do it. Upon spiritual reflection the man concluded that since God wouldn’t clean his apartment, it must be God’s will for him to live in the mess. Shortly afterwards he got drunk.

    Relapse & The Extremes of Non-mystical Spirituality 

    Other people relapse because they cannot find a higher power to believe in. Some of these people are overwhelmed with such intense shame and guilt that they can’t believe God or any other higher power is available to them. Others are locked into grandiosity. They see themselves as bigger, strong, and smarter than anyone or anything else in the universe. When they encounter overwhelming problems they feel cut off from all sources of courage strength and hope. They often become disillusioned and relapse to chemical use.

    Most people who succeed in recovery have organized their sobriety around a source of meaning and purpose that is greater than themselves. Most practice the mixed system of spirituality described in the serenity prayer. The Serenity Prayer is “God grant me the serenity to accept the things I can, God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference”.

     People who live in accordance with these spiritual principles recognize that there are things that they can and must change if they are to stay sober, and they seek the courage to make those changes. They also recognize that there are other things that are beyond their control. They turn these things over to a Higher Power. They have faith that there is someone or something bigger, stronger and more powerful than they that will take care of the things that they can’t manage. As a result, they can comfortably let go of the things that they cannot manage and invest their energies in taking care of things that are within their power.

    Recovery & A Balanced Sense Of Spirituality

    People who stay sober are able to transform themselves by surrendering their narrow, addictive world view and embracing a broader and more effective sobriety-based world view. This transformation is a spiritual process, though not necessarily a mystical one. It is a consciousness expanding experience that requires a belief that there is someone or something more powerful than I am. It requires a willingness to believe in a seek out that source of power, to ask for help, and ultimately to follow directions. 

    Recovering people need to find a source of courage and strength that can overcome frustration, transform despair into hope, and motivate them to move ahead in the sober life. Some recovering people find this in a mystical higher power that many call God. Others find it in the mysterious power present in their group conscience. Still others find it in a higher value system that replaces addictive thinking with rationality and reason.

    People who maintain sobriety learn that they are responsible for themselves. They internalize the AA principle of “easy does it, but do it.” They realize that they need to identify the next little thing they have to do to stay sober, and do it. In essence, they realize that they are responsible for whether or not they take the next drink or the next drug. They recognize that they must learn how to look within themselves and find the source of courage, strength, and hope needed to stay sober. Ultimately, they are responsible for rebuilding their lives and finding meaning and purpose in sobriety.

    The Spiritual Paradox of Recovery

    This is the paradox of recovery. We cannot do it alone, but yet we must do it by ourselves. We cannot expect God or a higher power to do what we are able to do for ourselves, but yet we cannot do it for ourselves without somehow touching a source of courage and strength that exceeds our own abilities. And here seems to be the ultimate spiritual principle that allows alcoholics to avoid relapse and move ahead in recovery. It is a philosophy of balance. It is the ability to recognize and affirm the quality of physical existence, to learn how the physical world operates and operate within the limits of its laws and imperatives. It is also the willingness to affirm the world of ideas, thoughts, and images. It is the ability to learn to turn within and find a creative spark of life, a creative spiritual energy that will allow us to go on and find solutions when none seem available. The balance of these two worlds, the world of physical reality, and the world of ideas where the ultimate spiritual reality exists, allow people to forge a strong and powerful sobriety.


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