THE DEFINITION OF RELAPSE 

May 10, 2015

By Terence T. Gorski

Here are the key points of the definition of relapse from a wide variety of internet dictionaries :

To experience a relapse means:

1. The return of a disease or illness after partial or full recovery from i

2. To suffer a deterioration in a disease after a period of improvement.

3. To fall back into illness after convalescence or apparent recovery

4. To have a deterioration in health after a temporary improvement.

5. To fall or slide back into a former state of illness or dysfunction.

6. To regress after partial recovery from illness.

7. To slip back into bad habits or self-defeating ways of living; to backslide after a period of progress.

8. To fall back into a former state, especially after apparent improvement.

Origin of the word RELAPSE: the word relapse comes from the Middle English word “relapsen,” and from Latin meaning to to “forswear” (to promise or swear in advance that a change will be made.   A combination of the words: relb or relps-, came to mean to fall back gradually; or to slide back without being able to stop ones self (as could happen when trying to move up a slippery or muddy hill.

The word relapse results from a linguistic process called “nominalization” which means to describe a process (like loving someone or relating to someone) into a thing (like love or relationship).

It is important to do a “cross-walk” between 12-Step language (i.e. dry drunk leading to a wet drunk) and the language of cognitive behavioral therapy (the process of falling back into an illness, condition, or habitual problem behaviors that ends in the act of drinking, drugging, or acting out an addiction or habitual self-defeating behavior.

Using an “addictive release” provided by an addictive drug or behavior is often seen as the start of a “relapse episode,” a single discreet episode of addictive use.

A relapse episode is usually preceded by stressful events (triggers), that raise stress and activate old self-defeating and addictive ways of thinking, feeling, acting, and relating to other people.

Marlatt distinguished between a lapse (a short term and low consequence episode of addictive use) and a relapse (a return to a previous state of out-of-control addictive acting out usually accompanied by a return of secondary problems related to the addiction.

I believe in a Twelve-Step Plus Approach that matches the needs of individual recovering people with a strong recommendation to attend 12-Strep Programs and to participate in other treatment activities (professionally supervised) and recovery activities (peer supported and community based) that meet individual needs, promotes long-term recovery, and uses appropriate relapse prevention methods. There is no wrong door into recovery. There is no wrong treatment or recovery activity if it helps people to live a sober and responsible life filled with meaning and purpose.

Language Programs The Brain,
Focuses The Mind, and
Motivates Behavior.

Think clearly to get results in recovery!

~ Terry Gorski Blog: www.terrygorski.com

~ Terry Gorski, via www.facebook.com/GorskiRecovery

www.relapse.org

— PERMISSION IS GRANTED TO REPRODUCE OR REPOST —

 


Relapse Prevention and Chemically Dependent Offenders 

March 2, 2015

By Terence T. Gorski

Review Gorski’ Books and Publications

From the mid 1970’s to the late 1980’s I worked extensively on projects involving the criminal justice system.

My primary focus was upon setting up programs lower recidivism to substance use and crime. During this project I interviewed many current and released prisoners, correctional and probation officers, and drug court judges.

The project resulted in the development of the three manuals related to relapse prevention among offenders that are still used in many correctional programs and training I institutes.

These are:

1. An Executive Briefing On Addicted Offenders for Judges and Policy Makers.

2. A Guide for Counselors, Therapists, and Criminal Justice Professionals;

3. The Relapse Prevention Workbook Chemically Dependent Offenders (for use by offenders);

4. Relapse Warning Signs for Criminal Behavior;

5. High Risk Situations for Incarcerated chemically Dependent Behaviors.

I also made the book available through the government printing office: https://www.ncjrs.gov/pdffiles1/Digitization/152332NCJRS.pdf

Here is the link to  blog page that briefly describes the information that we have. The publications are old, but the content has stood the test of time. All protocols within these workbooks are based evidenced-based practices of Relapse Prevention Therapy as certified by the National Registry for Evidence-based Programs and Practices (NREPP). The work books have been extensive used in the correctional system both behind the bars and in the community for over twenty-years. They are still valid because: They are based upon a rock-solic foundation of Cognitive-Behavioral Therapy (CBT), they utilize proven principles of Relapse Prevention, and the system is manualized making it easy to use consistently within a program.
We can make the workbooks available on a license tt individual facilities in reproducible PDF files that can be copied within the facility for use with the clients. If you are interested in obtaining a PDF License please email Tresa Watson tresa@cenaps.com or call here at 352-596-8000.

CERTIFIED RELAPSE PREVENTION SPECIALISTS (CRPS)

September 2, 2014

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An Evidence-based Program and Practice

By Terence T. Gorski, author,

Find A CRPS Near You

Find a CRPS providing services in your area. Click Here. Most provide a minim of thee services on a fee for service bases:

1. RP Counseling and Therapy:

Direct RP services for recovering people and their families in developing and supervising relapse prevention plans. Some do this in individual sessions and others in groups.

2. Clinical Supervision/Case Consultation:

Clinical supervision in RP for professionals in the community working with relapse prone people. Again, some do this in individual supervision and some use group supervision.

3. Training and Presentations On Relapse Prevention and Related Area:

Many of our Professionals who have earned their CRPS do. Wide variety of training events for professionals and recovering people in the community.

I have found the members of the Association of Relapse Prevention Specialists to be dedicated and competent professionals with big hearts. They are just plain good and trustworthy people.

You can locate a certified Relapse Prevention Specialist near you by visiting the CENAPS Website: Certified Relapse Prevention Specialists (CRPS)

 

Supervision.http://www.cenaps.com/The_Cenaps_Corporation/Certified_Specialists.html Supervision.

The Relapse Prevention Certification school id conducted ever November in Fort Lauderdale FL
BECOME A CERTIFIED RELAPSE PREVENTION SPECIALIST (CRPS):

 

 


Trigger Events

August 29, 2014

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The term “trigger even” is commonly used by people struggling to understand what turns on their addictive thinking, ear lying warning signs (drug seeking behavior), and the strong attraction or need to bet involved in high risk situations. Recovering people intuitively understand the idea of relapse because it is linked to the metaphor of a gun. When you are holding a  load gun and pull the trigger it fires. Addiction, especially in early recovery, is very much a like a loaded gun with a sensitive trigger.

When you pull the addiction trigger, the disease of addiction fires off addictive thinking, automatic addictive or drug seeking behavior, and a craving or urge that pulls you toward high risk situations. One you are in a high risk situation you have put yourself in a HIGH RISK SITUATION which takes you away from recovery support, puts you around people, place, and things that support addictive use and make it easy for you to use. The high risk situation also provides social support to start using and social criticize if you refuse to start using. In a high risk situation there is also usually the false promise that goes like this: “I can use my addictive substance just this once, no one will know, and I can just renew my sobriety tomorrow. That, of course, is a very dangerous way from a recovering addictive to be thinking.

Most recovering people intuitively understand what a trigger is, and can describe exactly what pulled the trigger and what happened after the trigger fired off the movement toward addiction.  The problem is that very few recovering people or professional can tell you what a trigger is.  Events and situations that act as powerful triggers for some people have no effect on others. Even more confusing, on some days a certain situation, like have lunch in a restaurant that serves alcohol, activates a powerful trigger. On other days, haven lunch in the same place with the same people does nothing to pull the trigger that activates craving. Why is this?

Many people mistaken believe that the trigger lives in the external person, place or thing that sets it off. As a result addiction professionals teach recovering people to identify and avoid common trigger events. Rarely do recovery people get a clear explanation of psychobiological dynamics that that make triggers so powerful. Without a clear understanding of the psychobiological dynamics of a trigger event, the only way to learn to many them is through trial and error.

Bob Tyler, in his book Enough Already!: A Guide to Recovery from Alcohol and Drug Addiction, explains it this way:

“If we don’t know what makes a trigger a trigger, the only thing we can teach patients to do is to avoid them. Now, how much success do you think our patients will have avoiding triggers living in this society which is permeated by alcohol and drugs? Probably not very much! Therefore, it is essential that we are knowledgeable about how a trigger actually becomes a trigger so we can teach our patients how to recover from triggers?” Although Bob Tyler talks about “recovering from triggers, and I talk about identifying, managing, and disempowering triggers, our basic concept is the same. Recovering people can learn to identify avoid, manage, and eventual, turn off the ability of the trigger to activate craving and drug seeking behavior. This happens spontaneously as people get into long-term recovery. There are techniques and methods for pan aging and disempowering triggers that can make the process a lot easier.

Trigger Event – Defined

A trigger event as “any internal or external occurrence that activates a craving (obsession, compulsion, physical craving, and drug-seeking behavior)” (Gorski, 1988). let’s break down this definition:

  • “internal” occurrences are thoughts or feelings;
  • “external” occurrences involve the five senses: sight, sound, smell, taste, and touch.
  • In order for something to be a trigger, such an event must be connected in some way to the person’s using alcohol to other drugs.
  • The trigger is stronger if the event happen just before, or simultaneous to, the actual use (Gorski, 1988).
  • The most important thing to know about what makes a trigger a trigger is its connection to the use.

Bob  Tyler explains it this way: “A simple way of explaining this is by relating it to classical (or Pavlovian) conditioning. Ivan Pavlov was a Russian scientist who won the Nobel Peace Prize in 1904 for his research in digestive processes. While studying the relationship between salivation and digestive processes in dogs, he would show a dog meat powder and measure the resulting salivation level of the dog – they did this repeatedly. One day, Dr. Pavlov noticed that when he walked into the lab, that the dog started to salivate even before showing it the meat powder. There appeared to be some connection made for the dog between Dr. Pavlov and the meat powder which caused it to salivate. To study this phenomenon, he added a third variable (a bell) and rang it just prior to showing the dog meat powder and measured the resulting salivation level. He did this repeatedly: bell à meat powder à salivation, bell à meat powder à salivation, etc. He eventually found that he could ring the bell, not present the meat powder, and the dog would still salivate. Thus, there was a connection made for the dog between the bell and the meat powder that prompted the salivation (PageWise, 2002). For our purposes, the bell is the trigger for the dog’s drug of choice – meat powder, which caused the dog to salivate for, or crave, the meat powder. The challenge for the addicted is to identify the bells (triggers) that cause them to salivate (crave) their drug of choice. This will allow them to avoid or manage such triggers until the time in their recovery comes to start recovering from them.”

Disempowering (Recovering from) Triggers

There are three phases in disempowering  a trigger:

  • Phase 1: Avoidance: Make a list of the most powerful triggers that were associated with you drinking and drugging and plan to avoid them.
  • Phase 2: Gradual re-introduction with adequate recovery support: If consciously exposing yourself to a trigger it is best to have a friend in recovery to help you prepare, go through the experience with the trigger, be their to help you get out, and then talk about the experience and the thoughts and feelings that it stirred up.
  • Phase 3: Extinction. Phase I is to “eliminate as many of them as you can, for a limited period of time, until stable” (Gorski, 1988). As stated previously, in very early sobriety, you do not go to bars or other using places, you avoid people who use and drink, and you avoid any other triggers you identify.

“The second phase is a gradual reintroduction of the triggers so that the person can learn how to cope with them” (Gorski, 1988). This does not mean to gradually re-introduce the addict into the crack house or their favorite watering hole, but there are some trigger situations that you should be able to eventually participate in. As stated earlier, alcohol permeates our society and you would have to live a very sheltered life in order to avoid it over the long-term. Therefore, in order to lead any kind of normal life, gradual re-introduction to some trigger situations is necessary. This re-introduction process is best done with the addict’s sponsor or with a therapist or group if they have one. Following is an example of this process in my own sobriety.

The following story reported by Bob Tyler gives and excellent example:

“When I was about 90 days sober and still involved in the aftercare portion of my treatment program, we were invited to the wedding of my wife’s cousin in Chandler, Arizona. I thought: “I’d really like to go!” However, I had learned from past experience that decisions I made on my own in relation to my sobriety were typically bad ones. So I decided to leave it completely up to my group and put it out to them. The consensus was that since I was still working a very strong sobriety program, going to daily meetings, and going with my supportive wife, I could probably stay sober if I created a sobriety plan. The group then proceeded to help me put this plan together.

  • Suggestion 1: Carry a Big Book (Alcoholics Anonymous) onto the plane and read it: The thinking was that since flying on an airplane was a trigger for me to drink, it would be difficult to order a drink while holding a Big Book in my hand. The book has an embossed cover so nobody would know what it was and, if they recognized it, they probably have one and I might meet someone in the program.
  • Suggestion 2: Keep you recovery support system close. If traveling, find out where the lo=cal meetings are and make telephone contact with one or more local members. Have a written plan to go to 12-Step meetings each day and have an accountability system built-in.  I was in Arizona. They had me call the downtown Los Angeles Central Office of Alcoholics Anonymous (AA) to get the number of the central office in Chandler, Arizona. I was to get a meeting scheduled for each day I was there and, if possible, schedule a meeting for the time of the reception so if I got into trouble, I could simply leave the reception and go to a meeting. In fact, this actually happened – here’s a funny little story:
  • Suggestion 3: Have an Emergency Escape Plan if Craving Is Triggered: Bob Tyler went to the reception.  “I found myself talking to my wife’s uncle next to the wet bar at his home.” Bob said.  “Suddenly, someone plopped down a bottle of my favorite whiskey onto the bar right in front of me. After recovering from my slight panic, I excused myself and informed my wife  that I was going to a meeting. She was supportive because I had talked with her about this emergency plan before we left.   Fortunately, I got the address and directions to the from AA’s Central Office before I left. This made it easier for me to go.”

After the meeting, Bob went back to the reception where he noticed “everyone was having a great time dancing. This really looked fun to me, but I had never danced sober before. I always had to have at least a few drinks in me first because I was not a very good dancer and cared too much about what other people thought of me. When I had a few drinks, I felt like I danced like John Travolta and you didn’t think so – too bad!” It’s amazing how many recovering people won;t dance in recovery because they fear it will make them feel stupid and activate a craving. Bob is not alone here. So Bob developed a plan:

He waited for a fast song that he liked, and slid onto the dance floor while playing “air guitar” and, and starting to  dance. “A Van Halen song came on,” says Bob, and I was off and running. Little did I know that just after I left for my meeting, the bride and groom arrived, walked across the portable dance floor, and everyone followed tradition by throwing rice at them. You can imagine what happened next. As I attempted to slide onto the dance floor, my feet hit the rice and came right out from under me. I hit the floor, followed by two of my wife’s female cousins (one of them the bride!) who I managed to take down with me – one of them right onto my lap. I rose to my feet with my beet-red face and, as I looked around the dance floor, I could see my wife’s family’s reaction which I perceived as, “There he goes, he’s drunk again” – and I was probably the only sober person there!”

Alcoholics and other addicts carry with them a reputation for doing stupid things when they are drinking or using. AS a result, any time they make a mistake or try to have fun by being silly, many people with just assume they have stated drinking or drugging again. This can activate shame and guilt and bring back painful members. It’s also easy to feel unfairly judged and to question the value of your sobriety. “If this is how people will always react to me, why bother to stay sober?” Needless to say, this kind of thinking a serious warning that needs to be discussed with your therapist and sponsor.

The other elements of his sobriety plan helped Bob get though this situation sober. He called his sponsor each day discussing everything that happened and how he felt about it. He read the Big Book for a half-hour each evening to keep is sober-thinking brain circuits alive and active., and not going anywhere alone. Upon returning, my group and I processed what worked, and what additional program tools I might have used so I could use them the next time I might have to expose myself to triggers.

Through this process of gradual re-introduction, Bob was able to participate in increasingly more activities in my recovery to the point I can now do almost anything without being triggered. This is due to the third phase of the recovery process called the “extinction process” (Gorski, 1988). As mentioned earlier, triggers become extinguished when repeated exposure to them is connected with not using, rather than using.

Addiction professionals can learn to prepare recovering people for living in a society that is alcohol and drug centered.  The trigger management process, or as Bob Tyler Describes it, Trigger Recovery, can help many recovering people improve the quality of their sober life and reduce the fear and risk of relapse.

References:

Gorski, Terence T. (Speaker). (1988). Cocaine craving and relapse: A comparison
between alcohol and cocaine (Cassette Recording Number 17 – 0157).

Independence, Mo: Herald House/Independent Press.

Pagewise, Inc. (2002). This study in classical conditioning is one of the most renown for its incredible results. Learn about Pavlov’s dogs [Online]. Available Internet: http://ks.essortment.com/pavlovdogs_oif.htm.

Tyler, Bob. (2005) Enough Already!: A Guide to Recovery from Alcohol and Drug Addiction

Books by Terence T. Gorski

Gorski’s book Straight Talk About Addiction describes trigger events in detail.

Gorski, Terence T., Addiction & Recovery Magazine, April 10, 1991

Gorski, Terence T.,  Managing Cocaine Craving, Hazelden, Center City, June 1990


Using Cognitive Restructuring for Addiction (CRFA) 

June 11, 2014

CENAPS_CRFA_ArrowBy Terence T. Gorski, Author
The Cognitive Restructuring for Addiction Workbook 

There is a simple formula for applying cognitive restructuring principles to nearly any problem. Here is how it works:
Write down both a title and a description for the problem. Here’s an example:
Title: Frustrated With My Job
Description: I know that I am in trouble with my recovery when I keep getting upset by little frustrations at work that I can usually handle well.
NOTE: Don’t use the exact same words in the title as in the description. Using different words forces your brain/mind to understand the problem on different level and from  different point of view. 
Start the TFUAR Analysis by completing the following statements: 
T = Thinking: When I am experiencing this problem I tend to think …
F = Feeling: When I am experiencing this problem I tend to feel …
U = Urges (Motivations): When I am thinking and feeling this way I tend to have the self-defeating urge to …
A = Action: When I experience that self-defeating rugs what I actually do that usually fails to solve the problem is …
R = Reactions: When I take this action other people tend to react to me in ways that make the problem worse by …
Complete the TFUAR Analysis Process by answering the following questions: 
T = Thinking:  What is another way of thinking that could help me approach this problem in a more effective wash?
F = Feeling: If I were to start thinking that way how would it change what I was feeling? Would that change in feeling help me approach this problem in a more effective wash?
U = Urges (Motivations): if my feelings changed in that way, how would my urges (motivations) to act out my old self-defeating behaviors change?
A = Actions: If my urges/motivations changed in that way, what new actions could I take that would help me to deal with this problem in a  more effective way?
R = Reactions: If I used the new actions, how would the reactions of others be likely to change in a way that would help me approach the problem in a more effective way?
By using this process of TFUAR Analysis over and over again every time you experience a problem, you will begin to develop new and more effective habits for dealing with problems.
For more I information on using cognitive restructuring in your life get The Cognitive Restructuring for Addiction Workbook and use it as the basis of a discussion group with other people you know who are committed to personal growth and development.

Understanding The Twelve Steps

May 12, 2014

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by Terence T. Gorski
Author

Millions of people have transformed their lives by working the Twelve Steps of Alcoholics Anonymous. Their success has come from their ability to truly understand these principles and to apply them in their daily lives. Yet for many embarking on the road to recovery, the Steps can seem vague, even confusing.

This practical, no-nonsense guide takes the mystery out of the Twelve Steps, presenting a straightforward explanation of what each step means, as well as examples of how it translates to real life. Written by a certified alcoholism and drug abuse counselor with more than twenty years of experience, it offers a wealth of wisdom, knowledge, and genuine support for anyone in recovery.
Understanding the Twelve Steps features:

Clear, easy-to-understand interpretation of the Twelve Steps — the vital building blocks of recovery.
This book provides checklists that summarize the tasks and objectives of each step.

This book explains:

– The Twelve Promises are the positive changes you can expect in your life if you follow the Twelve Steps

– What happens at Twelve Step meetings

– Why it is important to have a sponsor

– How the 12-step Program allows recovering people to share their experience, strength, and hope

From Library Journal

This highly accessible guide to the Twelve Steps of Alcoholics Anonymous (AA) that comes at a time when the popularity of such programs are at an all-time high. Drawing on his experience as an alcohol/substance abuse counselor, Gorski (author of Passages Through Recovery , HarperCollins, 1989) interprets each of the steps, and explains their importance in the recovery process.

This book provides valuable insight into how the steps can be “worked” or used by those trying to abstain from alcohol is also provided. While Melody Beattie’s Codependents’ Guide to the Twelve Steps (Prentice Hall Pr., 1990) focuses on the steps as they apply to people dealing with codependent issues, Gorski’s primary audience is the alcoholic. However, those newly involved in other 12-step programs (i.e., Al-Anon, Gamblers Anonymous, etc.) will gain better understanding from this. Recommended for popular psychology and self-help collections.

– Linda S. Greene, Chicago

Back to Understanding the Twelve Steps: An Interpretation and Guide for Recovering (Paperback)
About this item
Product Description
Millions of people have transformed their lives by working the Twelve Steps of Alcoholics Anonymous. Their success has come from their ability to truly understand these principles and to apply them in their daily lives. Yet for many embarking on the road to recovery, the Steps can seem vague, even confusing.
This practical, no-nonsense guide takes the mystery out of the Twelve Steps, presenting a straightforward explanation of what each step means, as well as examples of how it translates to real life. Written by a certified alcoholism and drug abuse counselor with more than twenty years of experience, it offers a wealth of wisdom, knowledge, and genuine support for anyone in recovery.
Understanding the Twelve Steps features:
Clear, easy-to-understand interpretation of the Twelve Steps — the vital building blocks of recovery
Checklists that summarize the tasks and objectives of each step
The Twelve Promises — the positive changes you can expect in your life if you follow the Twelve Steps
What happens at Twelve Step meetings and why it is important to have a sponsor
The experiences, strength, and hope of other recovering people

From Library Journal
This highly accessible guide to the Twelve Steps of Alcoholics Anonymous comes at a time when the popularity of such programs are at an all-time high. Drawing on his experience as an alcohol/substance abuse counselor, Gorski ( Passages Through Recovery , HarperCollins, 1989) interprets each of the steps, and explains their importance in the recovery process. Valuable insight into how the steps should be “worked” or used by those trying to abstain from alcohol is also provided. While Melody Beattie’s Codependents’ Guide to the Twelve Steps (Prentice Hall Pr., 1990) focuses on the steps as they apply to people dealing with codependent issues, Gorski’s primary audience is the alcoholic. However, those newly involved in other 12-step programs (i.e., Al-Anon, Gamblers Anonymous, etc.) will gain better understanding from this. Recommended for popular psychology and self-help collections.
– Linda S. Greene, Chicago
Copyright 1991 Reed Business Information, Inc.

About the Author
Terence T. Gorski is the president of The CENAPS Corporation, a training and consultation firm specializing in recovery from addictive disease and relapse prevention therapy. He is a popular speaker and conducts training and workshops in more than twenty different cities each year.

Mr. Gorski is the author of numerous books, audio, and video tapes, including Passages Through Recovery — An Action Plan for Preventing Relapse, Staying Sober — A Guide for Relapse Prevention, The Staying Sober Work-book, and How to Start Relapse Prevention Support Groups.

He is the clinical director of the National Relapse Prevention Certification School, which trains counselors and therapists in relapse prevention therapy methods.

Here is an excerpt from the book. © Reprinted by permission. All rights reserved.

Chapter 1: WHAT IS A TWELVE STEP PROGRAM?

This book describes the single, most effective program for the treatment of alcoholism. That program, of course, is Alcoholics Anonymous, best known as A.A. Alcoholics Anonymous is a worldwide fellowship of men and women who share their experience, strength, and hope with each other in an effort to recover from alcoholism. It is a voluntary fellowship. No one is forced to belong, but millions of voluntary members benefit greatly from their involvement. If you want to make Twelve Step programs work for you, you need to understand the fellowship of A.A. and how to work with it. This book is intended to help you do just that.

Many people find the miracle of sobriety by working the Twelve Steps. Since nothing else has worked for them, many believe that the Steps are mystical and magical, and, as a result, these same persons fail to search for and identify the underlying principles that make them work. Working the Steps can create the miracle of sobriety, but the miracle isn’t magic. The miracle occurs because working the Twelve Steps allows people to use powerful principles of recovery. Those who are willing to dig beneath the surface and truly understand the principles upon which the Steps are based are better able to use the principles in their lives.

The primary purpose of A.A. is to help alcoholics stop drinking. It was never intended to be all things to all people; however, A.A. recognizes that the Twelve Steps can help people with other problems. Thus, it allows organizations such as Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, Overeaters Anonymous, and others to use its Steps and principles. These related fellowships are developing as separate organizations so that A.A. can keep its primary focus on helping alcoholics to stop drinking.

A.A. is based upon a program of Twelve Steps to recovery that act as a personal guide to sobriety, and Twelve Traditions that act as guiding principles or bylaws for A.A. as a whole. Knowledge of the Twelve Steps is of critical importance to all recovering people for two reasons: (1) The Steps work if you work them, and (2) Twelve Step programs are inexpensive and readily available in most communities. As a result, they are the most widely used lifeline for people recovering from chemical dependence, codependence, and other compulsive or addictive disorders.

A.A. AS A NONPROFESSIONAL GROUP

As a result of the Traditions, A.A. is and shall forever remain nonprofessional. There are no medical professionals, as such, involved in designing or running A.A. or other Twelve Step programs. Although medical professionals do join as members, they have no more or no less influence on the organization than other members. Twelve Step programs do not provide medical or psychiatric treatment or psychotherapy. If you are involved in any Twelve Step program that has a psychotherapist in charge who runs it like a therapy group, be cautious. You are probably not at a Twelve Step meeting. This situation rarely, if ever, occurs in A.A.; however, it does happen in some of the newer Twelve Step programs.

If you are attending a Twelve Step meeting that is run by a psychotherapist who individually counsels the members, it is not a Twelve Step meeting; it is a therapy group. It is important to learn the difference, because Twelve Step meetings are based on the Twelve Steps of A.A. and the leaders act in a nonprofessional role.

A.A. members help themselves and others to stay sober. Members can be assured that they are not going to be solicited for donations or asked to get involved in anything else. Individual members of A.A. do have the right to participate in any religion, political forum, or cause that they wish. There are no restrictions. But they are not allowed to present themselves as A.A. members or to bring the name of A.A. into any controversy.

LEVELS OF TWELVE STEP INVOLVEMENT

Nobody is forced to do anything in A.A. It is one of the few organizations I know that supports the inherent constitutional right to do what we want. There is no coercion to participate on any level. If you want to belong, that’s fine. You are welcome to attend meetings and work the Steps. If you don’t want to belong, that’s also fine.

For most members, however, their involvement progresses through a number of levels. At the first level, they attend meetings. At the second, they read Twelve Step literature and discuss it with other members of the program. At the third level, they get a sponsor who can show them how the program works. At the fourth level, they start working the Twelve Steps. As members start to grow and change — a result of attending meetings and working the Steps — they are ready to move to a fifth level of involvement and begin sponsoring others. After they gain experience as sponsors, they are then ready for the sixth level of involvement, general service work, guided by A.A.’s Twelve Traditions, the set of principles that act as bylaws. General service work is designed to benefit A.A. as a whole. Notice the progression: Individuals help themselves first, then they help other people in the program, then they help the program as a whole. In summary, the levels of involvement are as follows:

1. Attending meetings

2. Reading and discussing A.A. literature

3. Getting a sponsor

4. Working the Twelve Steps

5. Sponsoring others

6. Service guided by the Traditions

Attending Meetings

You start working a Twelve Step program by regularly attending meetings. In A.A. it is said, “If you bring the body, the mind will follow,” because the Twelve Step program rubs off on people if they hang around long enough. Attending meetings isn’t a passive process. Working a program means you need to get actively involved, participating at the meetings you attend. The easiest way to take part is to say, “I pass” — a perfectly acceptable remark. No one in a Twelve Step program is obligated to say more. Most people, however, want to say more because they find it both enjoyable and beneficial. The more open and honest your comments, the faster you get well.

There is a joke that asks, “What is the difference between a drunk and an alcoholic?” Answer: “A drunk doesn’t have to go to meetings; an alcoholic does!” A.A. stresses the importance of attending meetings, especially during the first three months of sobriety. Many members suggest attending ninety meetings in ninety days. By doing “ninety in ninety,” beginners receive an intense exposure to the Twelve Step program and the people who use it. The principle that underlies doing “ninety in ninety” is a simple one — the more meetings you attend early on, the greater your chances of long-term recovery. There is no rule, of course, that you have to attend exactly ninety meetings in the first ninety days; go as often as your lifestyle allows. But keep in mind that the more meetings you attend, the faster you will get well.

Many members complain about having to attend meetings, but those who recover keep going even when they don’t feel like it. You don’t have to like going to meetings, you just have to keep going. Meetings are the lifeline to sobriety. When you attend meetings, you take a needed time-out from an alcohol- and drug-centered world and remind yourself that you are an alcoholic, cannot safely use alcohol and other drugs, and that you need the fellowship of other sober alcoholics to stay sober.

Reading Twelve Step Literature

The second level of involvement is to read Twelve Step literature and discuss your reactions, both positive and negative, with other members. The early members of A.A. identified the basic principles needed to get sober and stay that way. They compiled that information in two books — Alcoholics Anonymous (often called the Big Book) and Twelve Steps and Twelve Traditions. Both books are available from the central office of Alcoholics Anonymous in New York City. These books provide the basic principles needed to begin living the sober life.

Getting a Sponsor

After you feel comfortable going to meetings, making comments, and reading the basic literature, the third level of involvement is to get a sponsor. A sponsor is another member of the Twelve Step program who has more experience at recovery than you do. In order to get a sponsor, you must have participated in the program long enough to get to know people. Listen to the comments of others. Try to find someone you respect and admire, someone who knows more than you do about the program and can show you the ropes. In the business world, a sponsor is called a mentor.

When you find such a person and ask him or her to be your sponsor, you are in essence asking, “Would you be willing to spend time with me and teach me how you work the program?” There’s a slogan in the Twelve Step program: “If you want what we have, you do what we did.” And it’s primarily in the sponsorship relationship that this principle comes alive. You find a sponsor who has the type of recovery you would like to have, ask him to teach you what steps he took, and then try to do those things in your recovery.

A therapist does not take the place of a sponsor. You need a Twelve Step sponsor even if you have the best therapist in the world. A good therapist will encourage recovering people to become involved in Twelve Step programs and to get a sponsor. As a therapist, I don’t mandate Twelve Step attendance, but I do strongly encourage it. If someone refuses to attend even one meeting to see what the organization is all about, I may say, “If you’re not willing to go to Twelve Step meetings, I’m not willing to treat you. Why? Because if you’re not willing to go and find out what Twelve Step programs involve, I don’t think you really want to do what’s necessary to recover.” I base this attitude on an A.A. slogan: “We must be willing to go to any lengths to get sober.” If you are not willing to clear a few evenings and attend some meetings, I question your willingness …p

About the Author
Terence T. Gorski is the president of The CENAPS Corporation, a training and consultation firm specializing in recovery from addictive disease and relapse prevention therapy. He is a popular speaker and conducts training and workshops in more than twenty different cities each year.

Mr. Gorski is the author of numerous books, audio, and video tapes, including Passages Through Recovery — An Action Plan for Preventing Relapse, Staying Sober — A Guide for Relapse Prevention, The Staying Sober Work-book, and How to Start Relapse Prevention Support Groups.

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The Living Carcass: Zombies, Vampires, and Addiction

May 7, 2014

imagesBy Terence T. Gorski, Author

Addiction can turn an active addict into a living carcass — the empty shell of a real human person.

A carcass is “the outside part of a vehicle, building, or other object that is left when the rest of it has been destroyed.” In terms of addiction, it is the living shell of a person who has nothing left in life but their addiction.  The addiction has stripped them of the essence of being a human being and left a arational drug seeking creature in its place.

The zombie metaphor is very appropriate for addiction. The brain is attacked by the active addiction and the addict becomes a zombie, repeating the same addictive cycle without thought or self-control. Eventually zombies die or are killed or imprisoned by those who are still alive. The consequences of their own behavior condemns zombies to dwell in then land of the living dead and function on a subhuman level.

vamp123

I bite. You bleed. You may fight. I need to feed.

The vampire metaphor also applies to addiction. Vampires were once good people who were victimized by a predatory vampire. As the transformation from human to vampire progresses, need for blood grows. Even the vampires who still remember human sensibilities cannot resist the need to feed on blood, no matter what the consequence or how badly the act of feeding violates their values..

The analogy of the addict as vampire is best expressed in the book The Vampire Lestat by Anne Rice. It is a great book. Lestat is a likable vampire because he fights back against the inhuman need to feed on blood. He does not like being a vampire and goes to heroic lengths to rise above his nature and become human again. He hates himself for what he is and what he feels the compulsion to do. Yet he is what he is and cannot change his nature.

Fortunately, unlike Zombies and Vampires, people suffering from addiction can recover.

I have not seen any 12-Step for vampires. There is a book on the 12-Steps for Vampires by Michael Masden and a film entitled Vampires Anonymous.

LIVE SOBER – BE RESPONSIBLE – LIVE FREE

GORSKI BOOKS


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