Posts made in November, 2013

Addiction & Socioeconomic Status

Posted by on November 21, 2013 in Addiction and Recovery | 0 comments

Addiction & Socioeconomic Status

Melissa is now a contributor for Reach Out Recovery Magazine.

The news of a Florida Congressman being arrested for cocaine possession inspired her first article, the content of which is below.

While some believe addiction does not cross certain socioeconomic (SES) lines, it does. Although news reports of drug-related activity tend to involve individuals of low SES, the prevalence of addiction among high SES is comparable.

So why is it we hear much less about these cases? The simplistic answer is, individuals of high SES have more resources available to them. While these resources may be used for residential rehabs, sober companions, intensive therapy, monitoring, and accountability, the flip side is these resources may also allow the individual to continue drug use past the point where someone of lower SES would have lost his or her job and only source of legal income, physical possessions, relationships, and experienced additional natural negative consequences of his or her choices. It is these consequences that often motivate those struggling with addiction to seek help.

Unfortunately, we humans tend to be motivated more by pain-avoidance than we are by pleasure-seeking. While substance use may enhance one’s sense of wellbeing for a time, it is the dislike of what one is feeling before substance use that leads them to seek mood alteration through a chemical. That mood alteration is sought again and again until the development of substance dependence, in which one uses the substance(s) in an attempt to feel “normal” — that is, not in withdrawal. It’s a biological and psychological disease, that is either supported or discouraged by one’s social environment.

The line between support and enabling is fine and vitally important. Ultimately, the distinction comes down to whether or not the behavior increases or decreases the likelihood of substance use. Support comes with expectations  and consequences that are enforced when expectations are not met. The distinction, at times, is not easy to distinguish, especially among those emotionally  involved with the one using drugs.

A client recently shared with me that she had given her daughter cash so she would not have to prostitute in order to buy heroin. As an outsider, it could be easy for you and me to judge her reasoning as blatantly faulty. However, this mother truly believed she was helping – supporting her daughter – keeping her from dangerous situations.

I engaged the mother in playing the scenario through. She readily identified that her daughter would use the cash to buy heroin. “But,” she said, “at least she won’t be tricking.” “So you bought your daughter heroin instead,” I said. “Well, no … but … yes, I guess you could say that,” she responded. I asked if buying her daughter heroin made it more or less likely her daughter would continue to shoot heroin into her veins. The mother’s head dropped. “At least she wouldn’t be tricking.”

This conversation was not easy. Addiction is not pretty. This mother was desperate to save her daughter, whom she loves dearly, and was willing to go to almost any length to do so. Yet the manner in which she had chosen to act was making it easier for her daughter’s IV heroin use to continue.

As we continued to explore how scenarios could play out, another fear she identified was of her daughter going to jail. While no mother would outright wish such a thing for her daughter, this mother was able to see that time in jail could be exactly what her daughter needed – in order to experience the natural consequences of her choices – in hopes that they could lead her to say she’s had enough and ask for help.

Another family complained that their son needed help for a drug problem. He’d been kicked out of 3 highly respected colleges, for drug related activity. Each time, the father had used his connections and substantial donations to persuaded another college to admit his son. Still, his son failed to accept responsibility, get help, and prioritize his education – the response his father wished each of his attempts would bring. In fact, at the time of this conversation, his son was off sailing the family boat to the Caribbean.

The family believed their son had a drug problem. The son did not. Both were correct. The son’s drug use was costing him valuable opportunities, however another comparable opportunity soon came his way – without any effort of his own. His family kept paying his way, supporting his lifestyle, and making it easy for him to continue to use cocaine, marijuana, and copious amounts of scotch. Financially and emotionally, the family was picking up the tab for the son’s drug use.

The first example involved a middle-class family. The second, a family of ultra-high net worth. On the one hand, prostitution and jail may stand in stark contrast to getting kicked out of college. Yet, both this daughter and this son were on the exact same path – the path of addiction, which without recovery, eventually leads to institutionalization or death. Addiction knows no socioeconomic barriers.

Support and enabling are two different things. When we’re emotionally involved, the difference is much harder to discern. Support is available for the loved ones of those who use drugs. Al Anon is the most well known. Counseling can also be a source of support for the loved one and assistance to help them support and not enable.

Addition is not pretty. It knows no socioeconomic barriers. It is a family disease.

Help is available. Recovery  — for the one using drugs and those who love him or her – is possible.

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What is guilt? (Boundary series, part 3)

Posted by on November 13, 2013 in Skills Building | 0 comments

What is guilt? (Boundary series, part 3)

[The following entry was originally posted on Melissa’s Purposeful Living blog at]

Being raised in the south, I am well acquainted with guilt. Generations of southern moms have honed its use as a parenting tool. Grandparents, as well, find it motivational. Yet too often what gets called guilt isn’t really guilt at all. Let’s explore this.

In my work with clients, even those well beyond the south, it is common to hear the statement, “I feel so guilty.” “What is guilt?” I ask. And the conversation proceeds something like the following…

 “I feel bad.”

“Okay, so guilt is a feeling that does not feel good. What do you think its purpose is?”

“Well, I’ve done something wrong.”

“So, this feeling calls your attention to something you’ve done wrong. What do you think that is meant to do?”

“It lets me know I don’t want to do that again. And it lets me know I’ve hurt someone.”

“Guilt helps you learn of choices you don’t want to repeat in the future, and it lets you know when you have caused a wound to a relationship.”

“Yeah, and I can say ‘I’m sorry.”

“Guilt also prompts you to make amends. Hmmm. Overall, this sounds fairly positive. While is does not feel good for a time, guilt actually sounds like a helpful emotion. It  helps us to learn from our behavior and nurture our relationships. So why is it that sometimes guilt feels so yucky and won’t seem to go away?”

“Sometimes I have a hard time forgiving myself.”

“Tell me more.”

“I feel bad that I can’t make everyone happy. For example, a friend has invited me to attend a BBQ with her. I’d really like to go, but my son has a birthday party earlier that afternoon, and I know this will wear me out.”

“That’s a helpful example. Let’s apply your definition of guilt to it. You definitely feel bad. So you have that part. What is it you have done wrong?”

“Well, I haven’t done anything wrong. I could go, but I know I’d just feel exhausted and resentful.”

“If you said yes to her invitation when you really mean no – not because you don’t want to go but because you simply would not have the energy – you would end up feeling resentful toward your friend, who had done nothing wrong. This sounds different from the guilt you described earlier. What do you think the purpose of this feeling is?”

“I don’t know. It just feels bad, even though I haven’t done anything wrong.”

“There’s no lesson to be learned or choice to make differently next time.”

“Yeah, but I know she’s disappointed. And I am, too.”

“You both wish it could be different, yet you’ve not harmed your friend. You have nothing to apologize for.”

“I know she won’t be mad at me.”

“Even if she were, would it change the reality?”

“No. I still wouldn’t have the energy to do both.”

“We aren’t able to do all we wish we could. So how do you get past this feeling?”

“I’ve just got to let it go.”

“Admit you’re human.”

“Yeah. I know.”

As you’ve seen through this conversation, we call guilt two very different things. They may feel the same, but they’re not. To help clients start distinguishing between the two, I suggest we call them True Guilt and False Guilt.

True Guilt is actually a helpful emotion. It lets us know when we’ve missed the mark and caused hurt to a relationship, even if the other person does not know it. True Guilt prompts us to make amends and helps us learn of choices we do not wish to repeat.

In contrast, False Guilt is not helpful at all. It makes us feel bad when we have done nothing wrong. The other person may not be happy, yet we have done nothing wrong. False Guilt can, therefore, feel paralyzing – like a straight jacket. Changing our choice is not the path to freedom. Doing so would likely cause other problems, such as resentment or anger, which we would take out on ourselves or others. Admitting we are human – imperfect, with limited resources – and accepting that reality is the only way to get the straight jacket of False Guilt off. You have to put it down.

So next time you are feeling guilty – pause and examine it. Have you done anything wrong? Is it True Guilt or False Guilt? You may be surprised at what you discover.

In both my professional and personal life, I have found we tend to experience False Guilt much more often that True Guilt. So catch it – in the act! Give yourself permission to admit the truth. You are human. Put the straight jacket down.

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