In Act 1, Scene 3 of Shakespeare’s masterpiece, Hamlet, Polonius speaks these words to his son Laertes: “This above all: to thine own self be true.”
Substance abuse is fraught with manipulation, deception, denial and minimizing. Extracting the truth from a substance abuser is a yeoman’s task for the treating professional. Doing this type of work requires an inordinate amount of patience as the clinician attempts to sift through layers of deceit to determine if the abuser has the motivation to jettison the recklessness that is defining their lives.
Being true to myself means accepting that I’m not wired in such a way or tolerant enough to manage these treatment challenges effectively, so I don’t accept these patients. It is noble work and much needed, as substance abuse is rampant in this country, to say the least.
I have however devoted quite a bit of study to substance-related disorders during my many years in clinical practice and have given considerable thought to how abusers can help themselves. My comments and suggestions below focus on alcohol abuse, but can be applied to any drug or behavior for that matter, with abuse potential.
Step One: Ask, “Do I Really Have a Problem?” Our contemporary recovery culture has set the bar for being an alcoholic very low (much in the same way it has for depression, I might add). Anyone who can have one or two drinks and then return to the activities that define their daily living is almost certainly not an alcoholic. If none of their friends or trusted colleagues has ever pulled them aside and mentioned that their life would be much improved if they quit drinking, they’re probably not an alcoholic. If they can drink without their life going into the toilet, they shouldn’t allow anyone to even attempt to stop them.
Step Two: Tell Key People in Their Life That They Have a Problem and Are Trying to Fix It. It’s possible to get sober without spilling one’s guts at AA meetings. It’s impossible to quit drinking in secret. Alcoholics are very bad at turning down the opportunity to drink, and the world around them is replete with opportunities – cocktail parties, weddings, happy hours, birthdays and wakes. And as an alcoholic, they will seek out these opportunities and give into them. So the alcoholic has to enlist the support of trusted people in their lives by telling them about their problem and how they are trying to fix it. These key people are the ones who will be the alcoholic’s greatest allies pursuant to quitting.
Step Three: Initial Failure May be a Step Toward Future Success. Falling off the wagon doesn’t have to be a harbinger of doom. If the alcoholic messes up once, this should be embraced as part of the human condition. They get one mulligan and shouldn’t feel the need to share that one failure with anyone. They should soul search why this happened and make a personal vow not to do it again. Messing up twice though means they’ve got to go public with that failure. Friends and loved ones will likely offer support and praise for being honest. The alcoholic should take that praise and redouble their efforts.
Step Four: Quit Apologizing. The alcoholic will never be able to make adequate amends to those he or she has wronged. Talk is cheap and we all know how much more loudly actions speak. The best amends any alcoholic can make is to stay on the wagon — assuming they’re really sorry for how they’ve behaved.
Step Five: Figure Out What was Enjoyable About Drinking and How to Keep Those Things Alive Through Sobriety. No alcoholic becomes a different person merely by becoming sober. Their core personality remains; they’re just not using alcohol any longer to feel differently and perceive the world in a dissociative state. Anything done while inebriated can be done while sober. An alcoholic that had a streak for adventure, enjoyed dating or making others laugh for example, can keep those very same traits and pursuits alive through sobriety.
Those who drink too much have to figure out the causes for this and how the better aspects of their character can be pressed into service to aid in their recovery.
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Joe Wegmann is a licensed clinical social worker and a clinical pharmacist with over 30 years of experience in counseling and medication treatment of depression and anxiety. Joe’s new book, www.pesi.com. To learn more about Joe’s programs or to contribute a question for Joe to answer in a future article, visit his website at www.thepharmatherapist.com, or e-mail him at joe@thepharmatherapist.com.