ORTC Articles

What are affirmations?

Affirmations are an essential component of your ongoing recovery. To affirm means to declare something in a positive, firm, true way that is empowering. Affirmations are a way to change the messages of self-talk from negative to positive, from shameful and guilt-ridden to deserving and empowered. When many people first think of affirmations, they think of cute sayings that have little real power. But in truth, what you say is what you believe. Do you believe that you are worthy and deserve happiness, freedom, and empowerment? Can you affirm yourself with real conviction and meaning?

Affirmations are not a substitute for reality; they aren’t another way for you to exert denial, control, and reckless self-will over your life. Instead, they collaborate with surrender, spirituality, and your Higher Power.

Why are affirmations important to recovery?

You may have spent your entire life internally reciting restrictive messages about yourself and others. In recovery, you have faced your patterns of compulsion, denial, self-destruction, control, and inadequacy. But are you ready to assert that you deserve better? Are you ready to empower the good and the positive in yourself and in others?

The power to change is within you. But you have to believe it, say it, and live it.

How can you practice positive affirmations?

At first it feels awkward to practice positive affirmations. You may think, “I deserve to have a great job, a fantastic family, and freedom from pain.” But look in the mirror and say it out loud. It may seem awkward and even fake, but as time goes on, you will start to believe that you deserve these things, and the affirmations will become easier. You will start to notice that you are living the affirmations, creating a self-fulfilling prophecy that can only manifest itself by creating more positive energy in your life.

Recovery Action Step

Write down some loving, empowering affirmations for yourself. For example, “I am a beautiful person who is perfect just as I am today” or “I am a good person and I deserve to be happy.” Set a routine each day to read these. Look yourself in the mirror and believe them as you say them out loud.

Things you can do to affirm yourself and your recovery:

1. Work the Twelve Steps.

2. Read meditation/prayer books and focus on empowering thoughts every day.

3. Attend recovery groups or positive seminars or events.

4. Engage in positive self-talk, giving yourself new messages and new beliefs.

5. Write down affirmations of the positive life you imagine.

6. Surround yourself with people who support your recovery and believe in you.

7. Get a massage, go to a yoga class, or do something else positive for yourself because you deserve it.

8. Celebrate your successes with others.

9. Affirm others. Find out about the dreams and goals of others and support them.

10. Place affirmations in key places, such as on your desk at work or on the refrigerator at home. This way you will think about them on a daily basis.

Why do you need to resolve issues with challenging people?

There will come a time when alcoholics and other drug users need to resolve issues they have with challenging people. These enemies can be people or feelings, and we will have identified many of them through our Fourth Step. Step Eight instructs us to be willing to make amends to them whenever possible. The Big Book describes it this way:

It is harder to go to an enemy than to a friend, but we find it much more beneficial to us. We go to him in a helpful and forgiving spirit, confessing our former ill feeling and expressing our regret. Under no condition do we criticize such a person or argue. Simply we tell him that we will never get over drink- ing until we have done our utmost to straighten out the past.

Making amends can set straight feuds and fights that have lasted many years. It can make friends out of people who have challenged us, and at the very least provide the opportunity to have a civil relationship.

This directive does not include those who have been perpetrators of abuse. Abuse is never the victim’s fault. Making amends to someone who has hurt you physically, sexually, or emotionally is not the focus of this passage. It may help you in your recovery, however, to get to the point where you can forgive an abuser so you can be free of anger and hurt.

Feelings as enemies

Substance abusers have other enemies that are not human. Perhaps our greatest enemies are resentments, jealousy, envy, and fear. Alcoholics need to constantly monitor their feelings and handle them in healthy ways. They do this so that resentments and other strong feelings do not shatter their serenity and rob them of their sobriety.

What’s the difference between prayer and meditation?

Prayer is talking to your Higher Power. Meditation is listening to your Higher Power.

For most people, life is frequently fast-paced and stressful. Everyone needs time to sit back and gain perspective on what they are here for and how they are conducting themselves in their daily lives. This reflection and introspection— looking inside oneself—can be done through prayer and meditation.

You may pray frequently, or you may never have prayed. If you don’t believe in prayer, try acting as if you do. Start praying and see what happens. Members of Alcoholics Anonymous call this “Fake it until you make it,” which means that as you begin to act in accordance with spiritual principles, you will begin to grow spiritually. Whether or not you fully believe in the power of prayer does not matter right now. The important thing is to begin prayer and meditation with an open mind. You have nothing to lose and everything to gain.

Your prayers do not have to be complex. The Serenity Prayer may be as much as you can do:

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.

It’s helpful to think of prayer as a conversation—a conversation with your Higher Power. Keep it simple. Just talk about what’s on your mind, your concerns and worries. Nothing is too insignificant.

You may also want to explore other kinds of prayer.

What benefits will you get from prayer?

In the past you may have prayed, “God, get me out of this and I promise I’ll never drink or use other drugs again.” These prayers are self-serving. Instead pray for the courage to change and to confront the things that frighten you, threaten you, or make you angry. Pray for others, even those you don’t like. Use prayer to relieve the fears, grief, and anger that could cause you to relapse or return to alcohol or other drug use.

Prayers will bring you a sense of calm and well-being—a sense that you are part of a greater whole. It’s difficult to use alcohol or other drugs when you feel spiritually connected to your Higher Power and other people. But it’s easy to use substances when your heart is full of anger and fear.

On one level, prayer is about learning to accept external circumstances that you cannot change. But on a deeper level, prayer points to a fact about your inner life: you cannot directly control your feelings. However, you can influence your feelings through two other factors you can control: your thinking and your actions. Doing this moves you on to another quality described in the Serenity Prayer: courage. Courage allows you to seek spirituality and recovery one day at a time, while not letting fears or insecurities inhibit your spiritual progress.

What is meditation?

Meditation is all about listening to your Higher Power. The object of meditation is to clear your mind of racing thoughts, center yourself, and let go of fears, ambitions, jealousy, blame, and control. When you meditate, you will learn to listen to your inner self. Whenever your mind is racing with too many stressful thoughts of what you should be doing, what needs to be done, and what you should have done two weeks ago, focus on your breathing and make a conscious attempt to slow down and take full, long breaths. Soon, you’ll be able to use deep breathing to clear your mind for several minutes, and eventually even longer. When obsessive, stressful thoughts catch up with you, simply refocus your breathing. Keep practicing this, regardless of how many times it takes before you see concrete results.

How can you learn to meditate?

Like most worthwhile things, deep meditation is achieved through practice. With practice, you will learn to customize a method of meditation that’s right for you.

As a beginner, you may want to follow these steps to learn the basics of meditation:

1. Prepare the environment. Set aside a specific place and time. Consider shutting the door and unplugging the phone. Spiritual practice is about setting up a safe place that is free from distractions.

2. enter a state of relaxed alertness. Many spiritual traditions, such as yoga, emphasize posture. For example, sitting upright with a straightened spine promotes attention, alertness, and relaxation, all at the same time. Try different postures that feel comfortable to you and allow you to breathe deeply.

3. allow for uninterrupted silence. Listening begins as you quiet down. Freed from the compulsion to speak, criticize, or justify yourself, you can listen and gain direction for your life.

4. Listen and give acknowledgment. Step Eleven uses the term “conscious contact” to describe the state of being tuned in and listening with your deepest wisdom. When you receive guidance, let go of your own preconceptions about what should be and follow the inner guidance of your Higher Power.

What are some of the sleep problems that people experience in recovery?

When you were using alcohol or other drugs, your sleep pattern may have been disrupted. Now that you are in recovery, post-acute withdrawal from alcohol and other drugs can leave you feeling sleepless and exhausted. Don’t worry. This process is normal, and it happens to most people in recovery. Eventually you will want to establish normal sleep patterns. The average person needs between seven to ten hours of sleep each night.

Sleep is important because it allows your body’s metabolism to slow down enough to repair daily wear and tear. Roughly one-fifth of all slumber time is spent in REM (rapid eye movement) sleep; this is where large amounts of psychological healing work are often accomplished.

What is sleeplessness?

Sleeplessness can take several forms:

• difficulty falling asleep: one to three hours may pass before you can actually fall asleep
• early morning awakenings: you wake early in the morning and are unable to get back to sleep
• frequent nighttime awakenings: you fall asleep easily but wake up many times during the night

Many people worry about their sleep difficulties. This can create a vicious cycle: the more a person worries about being able to fall asleep, the more difficult it actually becomes. Once you get into bed, you may worry about things such as “Will I be able to sleep tonight?” or “Will I be too tired tomorrow to get my work done?” This type of worrying will only increase your level of physical arousal and impair your ability to sleep and relax.

Should you use medications to help you sleep?

Using medications to induce sleep can be unhealthy. Not only are many sleep inducing medications addictive, they can also make sleep problems worse.

Withdrawing from these types of drugs, such as benzodiazepines and barbiturates, actually cause a rebound effect where sleep difficulties temporarily worsen before improving on their own. This can be true even when the medication is not addictive. Many nonaddictive, sedating medications merely delay the process of correcting sleep problems.

Healthy options for improving sleep

There are many effective strategies for dealing with sleeplessness that do not involve using drugs:

• Take a hot bath or shower before bed. Doing so will increase your body’s core temperature and help you relax.
• Exercise four hours before bedtime, usually between 4:00 p.m. and 7:00 p.m. Mild to moderate exercise during these times will promote and induce sleep later in the evening. Exercising too intensely or too late in the evening may make falling asleep more difficult.
• Avoid caffeine. If you insist on daily coffee or sodas, limit your caffeine intake to the early morning. Switch to decaffeinated beverages after 10:00 a.m.
• Avoid using your bed for reading, writing, watching television, talking on the phone, or engaging in other activities that require mental alertness. Using your bed in this manner conditions your brain to react with increased alertness, which can keep you awake when you’re ready to sleep.
• If you are tossing and turning in bed after twenty to thirty minutes, get out of your bed, go to another room, and engage in some type of relaxing activity, like reading, stretching gently, or meditating. Go back to bed only when you feel sleepy.
• Use relaxation strategies. There are many different sleep tools available, including relaxation techniques and CDs or audio downloads. Try different tools until you find the one that works for you.
• Avoid naps during the day. Although a nap feels good when you are tired after a night of sleeplessness, it only makes the problem worse the follow- ing evening.
• Use “white noise.” A fan, relaxing music played very softly, or other background noise can allow the senses to relax rather than be alerted by sudden changes in noise level.
• Eat small amounts of carbohydrates, such as popcorn, toast, or cereal, prior to bedtime. Some carbohydrates contain tryptophan, the amino acid that the body uses to make serotonin, the neurotransmitter that slows down nerve traffic. A high-carbohydrate meal also stimulates the release of insulin, which helps clear from the bloodstream the amino acids that compete with tryptophan, allowing more of this natural sleep-inducing amino acid to enter the brain.
• Develop a relaxing ritual for the fifteen to twenty minutes prior to sleep, such as meditating, listening to relaxing music, and/or practicing relaxation techniques. This will help you relax your mind and body.
• It is important that you practice these techniques on a regular basis because lack of rest can set you up for relapse and an eventual return to use. Change in sleep patterns may not happen “overnight.” But by developing good sleep habits, you will be taking good care of yourself and ad- dressing sleep problems in healthy ways. If your sleep problems persist for more than six months during your recovery, contact your physician for a referral to a sleep clinic for a full evaluation.

Remember, you may experience periods of exhaustion during recovery. This is normal. If your exhaustion exists for an extended period of time, contact your physician to see whether there are any other underlying physical or mental issues that should be addressed.

Recovery Action Step

What are some strategies you could use to handle sleeplessness or exhaustion? Journal about these and create your own plan of action.

What are some typical dreams people experience in recovery?

It is not uncommon for those in recovery, even people who have been in recovery awhile, to have dreams of drinking or using. Not everyone has this experience, but many do. It is a normal part of recovery, and it is harmless. What those dreams mean from a psychoanalytic standpoint is not as important as the fact that they do happen, and they shouldn’t surprise you.

For example, some recovering people dream that they are drunk, but they’re sure that they haven’t taken a drink. Others experience chills, shaking, or jitters when they wake up, as if they had been drinking. Of course this is all a bad dream, but it can be alarming. Being unsettled by these dreams is good because it indicates that you are far enough along in your recovery to realize that sobriety is what you want—that you don’t want to go back to living the nightmare of using.

Here are some general guidelines for what to expect from your dreams during your recovery:

Early recovery

Drug and alcohol use interferes with normal sleeping. When the using stops, many people experience frequent and intense dreams. The dreams seem very real and frightening. Remember, these are a normal part of the recovery process, and you are not responsible for using alcohol or other drugs in a dream. Exercise is a tool that may help you lessen this dream activity.

Middle recovery

Dreams about using typically become less frequent after six months of recovery. When they do occur, they can create powerful feelings that last well into the following day. It is important to be extra careful to avoid relapse on days following powerful dream activity. Often, dreams during this period are about deciding to use or not to use, and they can indicate how you feel about those choices.

Late recovery

During this time, dreaming about alcohol or other drug use can help warn you when you are more vulnerable than usual to relapse and an eventual return to use. When you have dreams about using, review your situation and correct any problems you discover. Listed below are some helpful actions you can take when dreams begin:

• Exercise.
• Go to Twelve Step meetings or to other outside support groups.
• Call a counselor.
• Talk to sober friends.
• Take a break.
• Stay away from alcohol and other drugs.

The great thing about sleep when you are sober is that you can wake up with no hangover and no concerns about what happened the night before. You can wake up feeling hopeful and content—another recovery gift you’ll receive one day at a time.

What is paranoia?

Paranoia is a mental health disorder accompanied by the irrational beliefs that someone or something is out to harm you. These delusions typically involve excessive or irrational suspicion and distrust of others. Intense paranoia can result in homicidal as well as suicidal thoughts.

Methamphetamine, cocaine, marijuana, alcohol, and ecstasy are examples of just a few drugs that can cause paranoia. Use of these chemicals causes physiological stress that can lead to paranoia, anxiety, or hallucinations.

Symptoms of paranoia should subside once you become sober and start working an active recovery program. If symptoms do not subside, you may have a mental health disorder along with substance addiction. Mental health disorders, such as depression or anxiety, that accompany addiction are called co-occurring disorders. If you think you have a co-occurring disorder, seek help from a counselor or psychiatrist.

In a much milder form, paranoia can be one more example of the “stinking thinking” that is so often part of the alcoholic’s or addict’s mind-set. As users, we tended to take a self-centered view of the world, perceiving events as directly related to us. We can become paranoid about others’ concern for us or paranoid because of the things we did while we were using. Working an active recovery program is a positive way to deal with this milder form of paranoia.

Should you try to intervene if someone you care about has a problem with alcohol or other drugs?

Now that you are beginning to enjoy the serenity and joy of being free of alcohol or other drugs, you may find yourself growing concerned about the drinking or drug problems of your friends or family members. You may feel a strong need to help, but how?

First, be cautious. In early recovery, it can be very tempting to try to help the people you care about who have addiction issues—but don’t do it if it means you may sacrifice your own sobriety. In early recovery, the best way to help a friend or family member is by establishing boundaries and remaining focused on your own recovery. There is a lot of power in a changed life, and if you continue to get healthy, you may find others wanting to get healthy too.

If you make an effort to hang around using friends or family members in order to influence them to get help, you may be putting yourself into situations where it is difficult to say no. Going to the bar where you hung out while using or sitting at home with someone you always drank with—these are choices that could set you on the road to relapse.

Once you have some more time in recovery and feel much more solid in your sobriety, you can begin to look at how to help others. When you are ready, it might make sense to do an intervention on others. If so, here is some general information on interventions that could be of help.

How should you intervene?

It is extremely painful to stand by and watch as someone’s life is destroyed. That’s the position family members and friends find themselves in when an addicted loved one denies having a problem with alcohol or other drugs. Until that person admits the need for help, there is usually little that can be done.

It is possible to try to intervene in an attempt to help the addicted person see the broad impact of his or her use. There are actually people who lead interventions on a paid or volunteer basis. Professionals who conduct formal intervention meetings for addicted people believe they can help families and friends hold up a mirror to their loved ones, convincing them to confront their problem before they hit rock bottom—before they lose their job, health, and family.

The power of an intervention comes from the participants’ expression of concern and compassion for the addict’s welfare. One technique is to have family members and friends write letters to the addict and then read them aloud at the intervention meeting. The letters allow family members and friends to express their feelings without threatening or blaming the addicted person.

A family member or friend might say, “I love you, and I care about you, but I’m concerned. These are the things I see happening to you.” Then each person ties his or her own feelings to the statements. They might give examples of times they were hurt by the addicted person. For instance, a child might write or say, “You went to my basketball game, and everybody knew you had been drinking; I was so embarrassed.”

Intervention should stress love and concern. It should not take a negative, confrontational approach. The person should not be beat up by the intervention. Here are some additional guidelines:

• Participants need to be educated about the disease of addiction prior to the intervention. Their words should be concise, be well rehearsed, and should accentuate the positive.
• Interventions should take place in neutral territory. Find a location that will not feel threatening to the addicted person.
• People invited to the intervention should include family members, close friends, and, when appropriate, employers or fellow employees.
• Limit the intervention to about sixty to ninety minutes. At longer sessions, anger may flare up and compassion tends to decline.
• Schedule a substance use evaluation to follow the meeting.

Most intervention subjects will agree to the evaluation, but of course that is not always the case. That doesn’t mean the intervention has failed. Interventions never fail, because family members and friends get help, and the sooner they get help, the sooner their loved one will. The process plants a seed for recovery in the addicted person’s mind. It teaches family members and friends about the disease of addiction, how they may be enabling the addicted loved one, and how support groups such as Al-Anon can help them care for themselves.

While recognizing the value of formal interventions in individual cases, it
is important for families to think carefully about whether the process is right for them. If you want to work with a professional interventionist, shop around for one you will be comfortable with and check references.

Interventions are most successful when the alcoholic or addict is already close to recognizing that a problem exists. If somebody is right on the edge, an intervention can nudge him or her into getting needed help.

What is cocaine?

Cocaine is a central nervous system stimulant. It is a fine, white powder processed from the leaves of coca plants grown in South America. It is typically snorted but can be injected. Cocaine can also be added to other drugs such as heroin (this combination is called a “speedball”).

What is crack?

Crack cocaine, crack, or rock is a solid, smokable form of cocaine. Crack is the street name given to the form of cocaine that has been processed to make a rock crystal, which, when heated, produces vapors that are smoked. The term “crack” refers to the crackling sound produced by the rock as it is heated. It produces an almost immediate high, and the fact that it is inexpensive to produce and buy makes it a popular alternative to the more expensive powder cocaine.

What are the physical consequences of cocaine use?

Cocaine is a stimulant. Its effects can last from 5 to 10 minutes when smoked, or 15 to 30 minutes or longer when snorted, depending on how much is taken, as well as differences in body types and chemistry. Cocaine can lead to a num- ber of health issues, but most notably it can raise heart rate and blood pressure, leading to heart attack or stroke. Most cocaine-related deaths are a result of cardiac arrest. Cocaine users who inject the drug can also be exposed to HIV, hepatitis C, and other blood-borne illnesses.

The American Psychiatric Association (APA) uses the term “stimulant use disorder” to define a pattern of stimulant use that leads to significant physical, interpersonal, medical, or work problems. Stimulant use disorder is rated as mild, moderate, or severe based on how many criteria are met. A person diagnosed with stimulant use disorder can also be classified as in remission, or what is commonly referred to as “in recovery.” Those with stimulant use disorder should receive treatment, and those who identify themselves as addicts often find the skills and support to stay sober through peer support groups like Narcotics Anonymous.

Addiction is considered a brain-based disease characterized by abnormal drug-seeking behavior that leads to impaired control over one’s drug use.

Addiction means a person will continue using alcohol or other drugs despite the harm it does to their health, family, work or school, and relationships. An addict may experience withdrawal symptoms (physical pain, fatigue, depression, trouble sleeping, irritability) if he or she stops using, and may need to keep using just to feel normal. “Curing” addiction is not a matter of willpower or moral strength any more than is curing diabetes or cancer. Like diabetes and cancer, addiction is considered a chronic disease which is beyond one’s control and fatal if left untreated.

How does cocaine use affect a co-occurring mental health disorder?

Co-occurring disorders, or dual disorders, occur when a mental health disorder, like depression or schizophrenia, is present along with addiction, alcoholism, or other substance use disorders. Screening for co-occurring disorders should be part of any good assessment or treatment plan.

Cocaine can affect the same neurochemicals that researchers believe to be abnormal in bipolar disorder. Thus, the use of cocaine may trigger an earlier onset of bipolar disorder in people who are vulnerable to the disorder. It’s also possible that cocaine use could re-create depression or mania in people with bipolar disorder.

Chronic cocaine use can also worsen major depressive disorder, which can lead to increased use. As people with major depressive disorder use cocaine, they move from feeling euphoric to depressed and then, very often, paranoid.

Ritalin is a stimulant medication prescribed for people with ADHD. People using Ritalin should avoid any form of cocaine, because its abuse can lead to stimulant overdoses leading to heart problems, strokes, hyperthermia (elevated body temperature), and convulsions. Abuse of both cocaine and alcohol compounds the danger, increasing the risk of overdose, especially if the person is already using Ritalin.

How does cocaine use affect the brain?

When a person uses cocaine, there is an immediate rush of the neurotransmitter dopamine, which the brain’s neurochemical circuits perceive as pleasurable and rewarding. Because cocaine disappears from the brain quickly, chemical messages urge the user to repeat the experience as soon as possible. Thus, the user develops cravings for the drug.

As the user uses more and more, this causes a change in the brain’s reward system requiring more and more of the drug to achieve the same effect. This is called tolerance, and is one sign of a substance use disorder, or addiction. As the user requires more cocaine just to feel normal, this can lead to increasingly damaging behaviors.

Any form or amount of cocaine can do lots of damage to the body because it targets the brain and central nervous system.

Is addiction to cocaine treatable?

Yes. Treatment usually involves detoxification and outpatient or residential therapy. While no medications have been proven to reduce cocaine cravings, stimulant addiction has been effectively treated with a combination of methods such as motivational interviewing and experiential learning. The Matrix Model is a treatment model backed by more than thirty years of research. It was developed in California in the 1980s, when cocaine addiction was at record-high levels.

Addiction won’t go away, like a cold or the flu. It is a chronic disease, meaning you have it all your life. However, by staying sober and getting ongoing support, recovering people can live normal, healthy, productive lives.

Web resources

There are many resources out there. The websites for the following organizations were chosen for their usefulness and user friendliness.

National Institute on Drug Abuse (NIDA)

This government organization is dedicated to addiction research and education. Through its website you can access up-to-date publications about many different drugs of abuse as well as emerging trends.

Matrix Institute on Addiction

Learn about the Matrix Model of treatment for substance use disorders at the website for the Matrix Institute.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA is part of the U.S. Department of Health and Human Services. Its mis- sion is to reduce the impact of substance abuse and mental illness on America’s communities. Its website offers information and resources about preventing and treating addiction and mental illness.

How can you manage your caregiving role while still maintaining your sobriety?

Being a caregiver of an elderly parent or disabled loved one is never easy. It can be even harder if you are trying to be a caregiver while in recovery. The stress of taking care of another’s needs may be so great at times, it can lead to the desire to drink or use. If not dealt with in healthy ways, caregiving can be a dangerous role that could lead to relapse.

More than fifty million Americans care for a chronically ill, aged, or dis- abled loved one. Deborah, a recovering alcoholic, will be celebrating her birthday on Sunday. She plans to invite her aging mother for dinner because Deborah would feel guilty if she didn’t. But the truth is that Deborah would like to celebrate with her young children and be spared her mother’s litany of ailments and complaints.

“I love her,” says Deborah, “but my mother feels so sorry for herself that it’s hard to be around her a lot. I try to do everything I can for her. I’m constantly taking her to doctors. I have her over for dinner twice a week. I take her shop- ping. But I have a job and a husband, and my children need me. Plus I have my own health problems. It just gets to be too much.”

Love, a sense of commitment, or guilt may thrust you into a caregiving situation. Some take on the caregiving role willingly, others reluctantly. In either case, caregiving can disrupt family life, strain resources, and create emotional chaos. Deborah will need to take extra care of herself and keep working a strong AA program to avoid relapse.

Studies show that family caregivers are more likely than non-caregivers to experience strokes, heart attacks, depression, and anxiety. The stress and isolation brought on by caregiving may lead to feelings of anger, resentment, and grief. Caregivers are also at increased risk for unhealthy behaviors such as overeating and substance use disorders; those recovering from addictions may be at greater risk for relapse. As a recovering person, it can be particularly difficult if you are caring for a parent that never really cared for you while you were growing up.

While many caregiving situations may develop into an unmanageable bur- den, that doesn’t need to be the case. Caregiving can be a positive experience, one that brings families together during a difficult time. The Twelve Steps can help caregivers let go of the burden of caring for another. Caregivers can find serenity when they come to trust a power greater than themselves with the outcome.

Bob, a recovering addict whose mother died recently, relied on the Serenity Prayer when his mother’s health declined and she alternated between demanding his help and resisting it. “I used to worry about her falling, and sometimes I would get angry when she treated me like I was still nine years old,” he said. “But then I figured, what’s the point? I can’t change her.”

The Serenity Prayer helped Bob deal with his powerlessness: “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.”

Bob set some boundaries for himself. He learned how to say no without feeling guilty, and he practiced detachment with love. Detachment means respecting the other person’s right to make choices. It is remembering that you cannot control anyone else’s feelings, thoughts, or behavior, and that you are not responsible for them.

Detachment is a delicate matter for caregivers, who must step in when the relative can’t make sound decisions. Assuming the role of parenting your parent can be highly stressful. Detachment means taking care of yourself. Bob saw to it that his mother got good care, but he didn’t let her chronic condition trap him in a life of despair. Between visits, he found ways to relax and enjoy himself.

What resources are available to help you
in your caregiving role?

Caregivers seeking support and guidance may contact Children of Aging Parents, a national nonprofit resource and referral organization on caregiving for the elderly.

Other resources include the National Family Caregivers Association, the Family Caregiver Alliance, and the National Family Caregiver Support Program.

What is blaming?

As long as we blame others for things that happened in the past, we can’t accept our part of the responsibility, and therefore no growth or change can occur.

Blaming others enables us to hold on to anger and resentments and to avoid having to change ourselves. It’s the way we shrug off responsibility for challenges in our lives. It’s easier for us to believe that other people, places, and things make us angry, than to take responsibility for our part in the situation.

If you have blamed others for what’s happened in your life, you have kept yourself from looking inward and choosing what you could do to change things. The guilt trips you laid on your spouse, parents, children, friends, and co-workers did nothing to really change the sadness, anger, and frustration you were feeling. All blaming did was to turn your fear of those emotions and direct it outward toward others.

When you blame other people for what happens in your life, you give your power to those people, because your feelings become the responsibility of someone else.

Many of us blame others because it allows us to operate from a morally superior position. In your life do you notice that you always have to be “right” while someone else has to be “wrong”? Do you dominate others because you fear that you will be dominated? Do you usually have ideas about how things should turn out? Have you already decided that the outcome you have in mind is the “good” outcome and that others’ ideas are “bad” or “wrong”? If the answer is yes, then you need to work on blaming and controlling behaviors.

How can you stop blaming?

The only way to get out of this trap is to stop blaming. Begin by refusing to let yourself turn your anger and fear outward. Don’t blame, accuse, or point fingers at others for your own frustrations and longings. Working to let go of blaming will take lots of discipline, effort, and practice, because years of old habits are hard to break. But once you start to identify your blaming behaviors, it will be easier for you to take a deep breath, to be present in the moment, and to realize that most of the complaints you have are in the past. They don’t need to hold you back from what you can achieve now.

Before you can truly accept that you are powerless against the disease of addiction, you need to remove blame from your thoughts, actions, attitudes, and communications. You can then look inward instead of outward for solutions. You can be responsible for your relationships with your friends and loved ones and with your Higher Power.

Recovery action Step

Let go of blaming others and start looking inward to take responsibility for your life. Start by using “I” instead of “you” or “we” when you share your thoughts, feelings, and intentions.

1. Write down a brief description of times you blamed others for things that happened in your life.
2. Looking inward, take responsibility for your own role in what happened. Write down what you could have done to accept and come to peace with the situation, or what positive action you could have taken to change it.
3. Let your sponsor, recovery support group, friends, and family know that you are working to stop blaming others. Ask them to respectfully let you know when you fall back into blaming.

What is abuse?

Abuse is the use—or threat of using—physical, sexual, or verbal behavior to coerce another to do something. The abuser generally wants to degrade or humiliate, or to gain or maintain a sense of power or control. Abusive behaviors may include subtle or covert harm as well as life-threatening acts of violence.  These behaviors create an imbalance of power and control within a relationship or family.  There are several kinds of abuse—physical, sexual, and emotional—and each kind can take many different forms. Our society is so tolerant of abusive behavior that we often do not even recognize it as such.

What is physical abuse?

Physical abuse is any forceful nonconsensual physical behavior. It includes but is not limited to situations where a person is

• pushed, shoved, or hit
• held down, tied, or otherwise physically restrained from leaving
• targeted with a thrown object
• locked out of the home
• abandoned in a dangerous place
• denied basic physical needs such as eating or sleeping
• choked or burned
• threatened or abused with a weapon

Note that many of the above may not result in physical injury. The degree of injury is not what determines that an action is abusive. It is the behavior itself and the atmosphere of intimidation that defines abuse.

What is sexual abuse?

Sexual abuse is any nonconsensual sexual act or behavior. It is not just rape. It demeans and humiliates, making one feel shameful and exposed, particularly with regard to one’s sexuality. It includes but is not limited to situations where a person is:

• demeaned by remarks about body or body parts
• berated about sexual history, possibly including being blamed for being sexually abused or raped as a child
• called degrading sexual names
• treated as a sex object
• forced to beg for sexual attention
• forced to watch or have sex with others or pose for sexual photographs or pornography
• forced to engage in sex (rape)
• forced to do sadistic sexual acts

What is emotional abuse?

Emotional abuse is any verbal or nonverbal message given in order to threaten, intimidate, and degrade. It includes but is not limited to situations where a person:

• is belittled by name-calling
• feels frightened by another’s looks, actions, or gestures
• is treated like a servant
• feels controlled by the abuser, who monitors one’s activities and plans, conversations, and reading choices
• has concerns that are not taken seriously
• feels threatened
• is made to feel mentally unbalanced

Recovery Action Step

Can you relate to these three types of abuse? Write down a time in your life when you experienced emotional abuse. Some people were emotionally abused as children when they were called names on the playground and weren’t allowed to play with other children. Discuss the answers with your therapist, sponsor, or recovery support group.

What is post-traumatic stress disorder?

It doesn’t matter what type of abuse you’ve experienced, every type has a cost. That cost depends on the severity of the abuse. Many people suffer from post-traumatic stress disorder (PTSD), a debilitating condition that can develop after exposure to a terrifying event. PTSD affects both men and women. The event causing it may be something that threatened the person’s life or that of someone close to him or her.

Traumatic events that can trigger PTSD include violent personal assault such as rape or mugging, natural or human-caused disasters, accidents, or military combat. Whatever the source of the problem, some people with PTSD suffer from chronic memories of the trauma in the form of nightmares and disturbing flashbacks.

Other symptoms of PTSD include sleeping problems, feeling detached or numb, being easily startled, losing interest in things once enjoyed, and having trouble feeling affectionate. Irritability or aggressive behavior may result.  Reminders of the trauma may be very distressing and can lead to avoiding certain places or situations that bring back those memories. Anniversaries of the traumatic event may also be very difficult.

Many people have PTSD, especially those who have spent time in war zones.  PTSD is diagnosed only if the symptoms last more than a month. In those who develop it, symptoms usually begin within three months of the trauma. The length of the illness varies. Some people recover within six months; others show symptoms that last much longer. Occasionally PTSD does not show up until years after the traumatic event. If you suspect that you suffer from PTSD, it is best to see a mental health professional, psychologist, or licensed professional counselor for an accurate diagnosis.

What kinds of treatment are available?

Although PTSD is a mental health disorder, it can be treated with medical and behavioral interventions. Like others with mental health disorders, people with PTSD are highly likely to experience alcohol or drug use problems.

Cognitive-behavioral therapy, group therapy, and individual psychotherapy have been found to be effective treatments for PTSD. Studies have also shown that medications can help ease the symptoms of depression and anxiety. It is important to discuss medication options with a professional knowledgeable about substance use disorders because some medications can be addictive.

Where can you get help?

National Domestic Violence Hotline

The National Domestic Violence Hotline offers crisis intervention, information about domestic violence, and referrals to local service providers to victims of domestic violence and those calling on their behalf. Hotline advocates and volunteers have access to translators in 139 languages. They also offer resource materials on violence issues.

National Center for Post-Traumatic Stress Disorder (PTSD)

The National Center for PTSD was created to advance the clinical care and social welfare of America’s veterans through research, education, and training in the science, diagnosis, and treatment of PTSD and stress-related disorders. This website is an educational resource concerning PTSD and other enduring consequences of traumatic stress.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA offers a wealth of information on all mental health topics.

MaleSurvivor

This organization is for men who have been victims of childhood sexual abuse and rape. They offer a newsletter, a search tool to find licensed therapists by state, and professional articles on abuse.

Rape, Abuse & Incest National Network (RAINN)

This organization helps survivors of rape, incest, and childhood sexual abuse find counseling. It operates a twenty-four- hour toll-free helpline that connects people with rape crisis counselors in their area.

Survivors of Incest Anonymous

This is a Twelve Step group for survivors of incest and other childhood sexual abuse.