In reading a recent article by Therese J. Borchard. – the prolific, daily blogger and gifted author of BEYOND BLUE and THE POCKET THERAPIST – I felt it would be irresponsible of me not to respond to a concern she voiced a few days ago: "When Mental Health Recovery Clashes with Twelve Step Programs."
I urge you to read what Borchard wrote and what some of her followers say in their responses. I believe this topic is representative of so many problems we face when making decisions in our lives.
The solution lies in finding the most capable people and the best programs to satisfy the needs of each person, no matter what the situation or problem may be – psychological,physical or both.
We know that there are extraordinary people in every walk of life and there are wonderful programs for just about anyone suffering from any ailment, disease or disability. That being said, every excellent resource is, in my opinion, far out-numbered by mediocre and/or un-helpful ones. That leaves us with the responsibility to find those who will make the most positive difference in our lives.
At times these people may be family members or friends, but often they are those whom we don’t even know – authors whose stories speak to us in ways that seem so personal and touch us so profoundly; composers whose music makes our hearts jump for joy or weep from the richness of their rhythm; artists whose colors, shapes and visions expand our own journeys through time and space – any number of people who have helped enrich our lives, shift our moods, taking us to safer places.
However, the flip side of that is the fact that the opposite is also true. There are those in our immediate family or circle of friends who do not know how to be helpful. There are also those who call themselves professionals but who do not behave professionally and whose proclaimed expertise does not serve us well at all.
Therefore, we must do whatever we can to seek the help that will be most useful. That is as true for addicts as it is for the majority of people who are "garden variety neurotics" or anyone suffering from a very real and debilitating mental illness.
When an addict finds the courage to enter the room of a 12-Step program and is greeted by members who are rigid and tied to archaic beliefs, where judgement is freely dispersed, then chaos and self-doubt will become overwhelming and recovery will be sabotaged.
Even after an addict is drug-free and attending meetings, a proper psychological or psychiatric diagnosis can't usually be made during the first year of sobriety. The chief goal during that year is to remain abstinent. Period. Of course, in some situations when depression or anxiety lingers for months on end, such people usually benefit from a psychiatric assessment and medication will be prescribed even before the most accurate diagnosis can be made. That is something that 12-Step Programs frowned upon years ago. They saw it, as even the medical community saw it, as substituting one drug for another and they discouraged members from ever taking anti-depressants or anti-anxiety medications (not only during the first year of sobriety but during every year thereafter).
As the song goes: “The fundamental things apply ... as time goes by ...”
In this context, the fundamental things are the physical and mental well-being of all people and the goal is to achieve the health necessary to overcome whatever impedes peace of mind, happiness, and the ability to succeed.
Yet, help is not found by pitting a 12-Step self-help program against psychotherapy (with or without medication). That's a clear recipe for disaster. In fact, in my experience, those who succeed in maintaining their sobriety, gaining insight and altering their lives for the better, more often than not, are those who attend meetings and at the same time are processing their life choices with the help of a qualified professional.
Today, there are 12-Step meetings where the members have evolved as society has and where they will gain support in whatever ways they need. Equally true is the fact that there are psychotherapists who understand addictions and are trained to treat addicts with the respect they give to all their patients and the expertise to help them find their way to a life worth living.
What all of us have in common is that when we’re in physical or emotional pain we need whatever help is available to rid us of that pain. What we need least of all is a quick fix! We need a solution that will cure what ails us today and helps prevent today’s pains from recurring tomorrow and the day after tomorrow.
Returning to Borchard’s well-founded assumption that self help groups (particularly 12-Step Programs) do sometimes clash with mental health models, I think that is particularly true when ignorance abounds with regard to understanding the chemistry of the brain, for there is a very real need for some to take medication when their suffering is often a question of life or death. In such instances, none of us can afford to play God. We owe it to ourselves and to our loved ones to do our homework, to find the programs, the physicians and psychotherapists that suit the needs of those who are suffering. We must be MINDFUL and reach out to whomever we know who has walked the walk before us. If we don’t have that luxury, there is always the internet and the Yellow Pages, which list every clinic and health care provider in our areas of residence.
What we cannot afford to do is NOTHING. We cannot allow personal prejudices, feelings of embarrassment or fear to deter us from getting help for ourselves or anyone whom we care about.
Most importantly, it is the height of ignorance to believe that taking medication is a sign of weakness or that it deadens the brain or the soul. Quite the contrary. Alcoholics and those who are addicted to illicit drugs do, over time, fry their brain cells, become paranoid and worse. Psychotropic medications, on the other hand, aim to correct the faulty wiring in our brains that may be damaged, thereby improving the quality of our lives.
Whether or not someone is given a psychiatric diagnosis, and whether or not the need for medication is indicated, changes in lifestyle must occur for all those in recovery. Daily habits, the self-talk done that is destructive, the people, places and things which surrounded the addict during the times when he/she was "using" must all change. Similarly, attending 12-Step meetings can often be a life-line but it doesn’t magically rid one of his/her addiction, and while gaining spirituality is a bonus, it is not a panacea. Work has to be done in both AA and with therapists, if growth and change is to occur and if lives are to be saved.
When the clash that Borchard refers to between the goals of Recovery in 12-Step programs and the goals of Mental Health do occur, that is, in my opinion, the recipe for disaster which I referred to earlier. It is especially dangerous for those who are dual-diagnosed. If they do not feel they can freely take advantage of the best of what AA and the medical community has to offer, they will miss out on being served by the brotherhood of survivors in a 12-Step program along with the benefits of talk therapy and/or medication. When that occurs, such deprivation tells us that not enough is being done to enhance the body of knowledge in their mental health community as well as in the information disseminated among the sponsors and leaders in their self-help community.
When talking with people who are depressed, anxious, or suffering from recurring bouts of mental illness, therapists often say it's their depression talking, its the voice of their dis-ease, and at such times - if addiction remains a choice - health is out of reach. We, as a nation, can ill-afford to further cloud the options available to those who so desperately need support.
I wish everyone sobriety, sanity and the ability to live life peacefully and mindfully.