Supporting Documents – Partnership e-Learning

In this call, Pat went over the presentation she gave to a group of parents in Manhattan regarding Positive Reinforcement. We had several people on the call, who had great advice for thinking about “free reinforces” and “little fish” / “big fish” reinforces. This could be really helpful if your caller is struggling with positive reinforcement and/or you want to hear others’ ideas, especially now that the holidays are almost upon us.

10/17/17 - All Groups Call - Pot's Safer than Alcohol...So What's the Big Deal?

2/7/17 All Groups Call - Healthy Boundaries

1/24/17 All Groups Call - Co-occurring Disorders Presentation

10/4/16 All Groups Call - Blog Post Response

The following is the blog post response we discussed on the call:

“Listen? That is NOT a solution and completely worthless pop psychology. Listen to a begrudging addicted enabled adult sibling who manipulates my exacerbated parents? This adult sibling takes NO responsibility for their own life, nor has any motivation to do anything honorable or helpful for anyone else. The withdrawal and reduction has been going on for far too long. Parents bailing water from a leaky ship not worth rehabilitating!

“I cut this sibling out of my life and it has been a huge point of contention in my otherwise great relationship with my parents. My parents should do the same and stop listening. Listening = enabling.

“I think the solution is to drop the addicted adult child off in a remote location and let the grown child sort it out his/her issues. NOT in the parents home or in an over priced rehab program. Most of these drug addicted adult children need to go face the 3rd world, buck up and see their selfish ways. Listening is enabling.

“Terrible advice! This is why I would never waste my life raising a child that costs a ridiculous amount of thankless energy and money. And by the way, this adult child I reference was raised in a loving family by educated parents. No excuses. Very frustrating for me to watch.”

9/20/16 - CARA Webinar

8/23/16 All Groups Call - Case Study

8/23/16 All Groups Call - August 2016 Survey Results

8/9/16 All Groups Call - Notes from Support Group Meeting

From Pat:

Below are notes I sent to the families that attended my most recent support group meeting that I alluded to last night. They might be helpful for you as well when talking to your callers.

Sometimes it’s easy to focus on what we would like our loved one (LO) to do, losing sight of what we are doing that may not be helpful or effective. Some of the less helpful coping strategies/behaviors (adapted from SMART Recovery for Family & Friends) are listed below with an alternative coping strategy in parentheses.

Keeping your LO’s behavior secret from family and friends. This usually involves feelings of shame and guilt – shame that this problem has touched your family and guilt wondering what your could’ve, should’ve, would’ve done differently as a parent to prevent this from happening. There is great fear of judgment. As several group members shared, you did not cause this and it is not the result of bad parenting. As for telling others, you might be greatly surprised at a) how understanding they are, and b) they, another relative, another friend, a co-worker, etc., are dealing with the same issue. 23 million Americans face this issue, which means another 46 million parents – so know you’re not alone. (Build a strong support network)
Covering for or “protecting” your loved one.This often takes the form of making excuses on their behalf as to why they couldn’t be at work or go to a family function. This results in softening or eliminating the natural consequences of their behaviors and robs them of an opportunity to learn from their actions. (Allow natural consequences)
Nursing thru a hangover or withdrawing from other drug use. This also acts to minimize the impact of their behaviors and sends a message that mom or dad will help me when I’m using. (Withdraw negative reinforcements)
Being controllingby searching the house and their belongings to find their stash and get rid of it, or track their whereabouts, or who they are talking to to try to get them to stop using. This results in a cat and mouse game that exhausts all involved (Establish consequences that you will follow through on).
Supplying your loved one to keep them safe so that they aren’t in public where they could get a DUI or arrested for possession (Enabling by reinforcing behaviors you don’t want to increase).
Nagging, lecturing, pleading and getting angryto try to get them to stop. We often think that if we could just get them to listen about how destructive their behaviors are, they would stop (Use listening skills including open-ended questions, affirmations, reflections and summaries).
Trying harder to be a better parentout of a sense of guilt that you must have done something wrong to cause this (Engage in Self-care).
Obsessing over the addictive behavior– thinking about it in every waking moment as if your worry will fix the problem, instead of making you more anxious (Engage in Self-care and handling emotional triggers).
“Rescuing” your loved onewhen things get tough, such as giving him money when he runs out due to his substance use (Allow natural consequences).

It’s helpful to look at these ways of coping and ask yourself, “Is this working?” and if not, what are YOU willing to do to change? We will spend time over the coming months discussing how to cope using more effective strategies including those highlighted above, but I thought I might address #8, obsessive thinking.

Obsessive thinking usually involves a lot of “what if” thinking. What if she doesn’t graduate? What if he loses his job? What if my co-workers find out about my child’s drug use? What if he overdoses? What if she never wants to quit? You get the idea. Most of this type of thinking is fear of a future that is unknown to all of us. I don’t know about you, but my crystal ball is pretty fuzzy and just when I think I know what is going to happen, something else occurs that I hadn’t planned or accounted for in my “what if” thinking. I’ve also learned that my worry did not change my son’s drug use — I would stay home on a weekend waiting for another shoe to drop while he was out having a good time with his friends. It is also important to recognize that your worry is not a proxy for your love.

What I want you to take away from this is to catch yourself when you drift into “what if” thinking territory and pull yourself back to the present. In the present moment, what is happening? Remember, the situation can change on a dime and there are many paths to recovery – perhaps, not in the straight line you would wish for, but it happens all of the time.

7/26/16 All Groups Call - Case Study

On this call, Pat shared a letter a Mom wrote and then the son’s response. Here is Pat’s intro and both letters for you to read:

Coaches, here is an excerpt from an email that a mom sent to her college age son, Jimmy. By way of background, he was arrested for possession of opiates and has been attending the Vincent Center (all names have been changed to protect identity) in another state. The Vincent Center serves the purpose of an intensive outpatient program as far as probation is concerned and they give Vivitrol shots, but no therapy to speak of with it. Further, they only drug screen for opiates, so Jimmy is abusing Vyvance, alcohol, marijuana, medical marijuana and Klonopin (a benzo). As you read through it, what do you think the mom did well and what CRAFT skills would you share with her if you were her coach?

From the Mom:

“I’m sorry you had a rough night. I know how much your reputation as a strong baseball player means to you.

I made an appointment for you: 10:00 AM on 6/22/16 in NYC for a vivitrol injection. It’s the first appointment of the day, so you shouldn’t have to wait. We can cancel that and go to the Vincent Center if you prefer. Up to you. I also made you an appointment for this Friday night at eight for you to see a counselor. He is in Montville and approved by IDRC.

I know you like the Vincent Center. It serves as a great ‘cover’ for you. You get credit for participating in an IOP without actually having to engage in the process. I feel the Vincent Center has done nothing to help you. It’s your ‘outpatient treatment’ without any therapy, guidance, or support, and honestly, I think you need support. Your lawyer has told me he strongly feels you need inpatient rehab again. I told him I don’t think that’s an option.

“Jimmy. I know this hurts to be reminded of this, but I am still trying to make sense of your behavior. You were in PTI. A gift. All you had to do was fly under the radar. For some reason, despite my excessive warnings and pleadings ( met with your disdain and irritation) and your lawyer’s strong advice, you smoked weed in your car and got caught. Then I went into full mom- warrior mode and wrote 15 letters and you miraculously got a reprieve. But then you drank and smoked weed in your car again and now you’re a felon. Honey, you are, as you stated “hell bent on destroying your life”.

Your pre-occupation with drinking and smoking is taking its toll on your life. I know you think of it as recreation and medication and I have stayed quiet because I fear your rage, and am heart broken by how fragile and damaged you appear to be, but the truth is, you’re either incapable of grasping the severity of your situation here or you are an addict. You seem to be incapable of smoking pot in a reasonable and responsible manner. I mean YOU BRING IT WITH YOU EVERYWHERE. If police had pulled up to the field where you were playing last night, you would be in jail right now. The truth is, your next violation will send you to jail.

“I would do anything to see you at peace. More and more of your life seems embroiled in conflict, disappointment, exhaustion. What you ‘learned’ in rehab must seem a foreign language by now. Anyway, your lawyer has reached out to me and suggested you get help. He has told you himself that he has no faith in the Vincent Center. I’m happy to take you there for a shot, but I really believe you need someone to talk to.

“The counselor’s name is Jack Smith. He is young and laid back. Better yet, he is in network. So, only a ten dollar co-pay ( which I will pay)

“You have to tell me if you are willing or able to see this counselor on Friday night. I need to cancel within 48 hours. meaning I need to cancel by seven tonight. I could not possibly love you more. Your pain is mine.

“Hope your day gets better.

“Let me know if you need to be picked up in Montville and taken to the field. I can bring Burger king. Infinity and beyond.”

Mom

Son’s response to the Mom:

“I’m doing the best I can. I don’t know what you want me to say. If you want to continue to criticize me for decisions I have made in the past, that’s fine but I refuse to continue apologizing for that evening when I drank and drove. I learned my lesson and don’t plan on repeating the mistake.

“You only know how to put the bad shit under a microscope. I get what you are saying about the weed and you have a point, but what are you talking about when you say I have an obsession with drinking?

“Not to mention it’s been almost two years that I have avoided all opiates, but of course that doesn’t mean anything to anyone. The opiates were obviously a big deal, so I understood your concern. Once I proved I could stay clear of them, your next project was my finances. You wanted me to get organized and I did. Now, you’re just moving on to your next behavior modification goal. It’s not fair. In your eyes I am NEVER doing anything right and never; there is always something I should be doing differently because you think you have all the answers. I guarantee you if I stopped drinking / smoking entirely it would only be a matter of weeks before you were on me about vaping and then eventually you would tell me I have to stop playing games on my phone. What you don’t seem to understand is that you can not change the fundamentals of my personality.

“I really don’t know what type of scenario you have idealized in your head; one where I am 100% sober and become a missionary? One where I am cheerful and happy 100% of the time? I have news for you- there are few people capable of this type of life and I am not one of them. My life is hard right now and the understanding that I have no one to blame but myself makes me angry sometimes. There is your analysis- I don’t know why you think I need to talk to someone to figure that out. I am composed most of the time, but sometimes I need to let the fumes vent.

“I am not a happy-go-lucky person. I have struggled with anger / depression my whole life; no period of sobriety and no medication and no therapist is going to change that, but it’s okay because it’s not intolerable. I am alright; stop telling me I am not. It’s like you’re trying to make it true. I am not sure why you are so convinced that this one will be any different than the other 74 therapists I have seen. More times than not, they end up just making me more angry than when I walked in. But whatever you want.

“I won’t bring weed into public places anymore. Anything else, boss?”