Therapy steps

Twelve Steps can help manage various types of chronic illness

For more than 75 years, the Twelve Steps of Alcoholics Anonymous have worked for many people with alcohol and other drug problems. Today, the therapeutic value of the steps extends far beyond the field of addiction.

Physicians, therapists and other health care professionals are finding that the steps can help people with other chronic illnesses (eg, cancer, heart disease, diabetes and mental illness) find hope and healing. There is increased recognition that a spiritual component, such as the Twelve Steps, is important in addressing mental and physical illness.

One of the first things people realize when they have a chronic illness is, “Oh my God. I’m going to die and I don’t have the ability to heal this myself.” In any sort of chronic illness, people must face the fact that there’s a large measure of their illness that is outside their control.

They respond in a number of ways. They may deny the problem; they respond with shock, helplessness, depression, anxiety, grief, guilt, shame, anger, resentment, self-pity or defiance. They may delay seeking treatment or completely avoid seeking help, or they may become preoccupied with trying to control their fate.

People with a chronic illness face the same basic challenges as those with addiction:

1. accepting the reality of their disease;
2. tapping into help, resources and a power greater than themselves; and
3. maintaining hope as they live each day with their illness.

“The Twelve Steps can be conceptualized as a powerful behavior-change model that can be applied to many health problems, such as anxiety, depression and eating disorders,” said Tim Sheehan, PHD.

“In Step One (We admitted we were powerless over alcohol — that our lives had become unmanageable), the emphasis is on recognizing what I do and don’t have control over. Step One involves becoming a better observer of reality, taking stock of ourselves, and eventually empowering ourselves. As we admit that we are powerless over some things, we begin to recognize what we do have power over. We have power to cope with our current feelings and change our behavior.

Steps Two and Three focus on a solution and empower us to take action, added Sheehan. Step Two says I can be restored with the help of “a Power greater than ourselves.” That power can be anything that prompts a fundamental change in thinking and action. Step Three involves making a commitment to using the resources and other powers that are available to us.

Mental health professionals in particular are increasingly recognizing the power of the Twelve Steps in treating a variety of mental illnesses, including anxiety, depression, personality disorders and schizophrenia.

“The steps coincide with the process of recovery for any chronic mental illness,” says Kenneth Minkoff, MD. “The second step involves asking for help from a power greater than yourself. That could be medication, a doctor, a spiritual being, a support group or something else.”

Keeping hope alive is an important part of living, with any type of illness. Research supports that our state of mind directly affects our body’s ability to heal and fight disease. For instance, David Spiegel, MD, studied a random sample of 86 patients with advanced breast cancer and found that the group assigned to weekly support-group therapy had a more positive mental attitude and survived nearly twice as long as the patients who didn’t receive the psychosocial intervention.

Recovery is not just about arresting the disease, but about learning to live with a chronic illness over time. What do we need to do to make our lives manageable? Alcoholics have a diet: no mood-altering substances. From there, they need to go on to deal with the rest of the illness in terms of how they live with life’s pressures. They take inventory of their lives (Steps 4-9) and they grow spiritually through prayer and meditation and by getting with people who share their vulnerability (Steps 10-12). They also live the paradox of recovery: To keep the Twelve Step program, we must give it away.

Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden.

• See also
• Alcohol Related Brain Damage
• Effects of alcohol on women
• Of Course You’re Angry, Second Edition
• Diet & Health Books
• Self-care

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The brick wall of insanity

As opposed to the 12-Steps to recovery

1. I decided I could handle my emotional problems if other people would just quit trying to run my life.
2. I firmly believed that there is no greater power than myself, and anyone who said so was insane.
3. I made a decision to remove my will and my life from God who didn’t understand me anyhow.
4. I made a searching and thorough moral inventory of everyone I knew so they couldn’t fool me and take advantage of my good nature.
5. I sought these people out and tried to get them to admit to me, by God, the exact nature of their wrongs.
6. I became willing to help these people get rid of these defects of character.
7. I was humble enough to ask these people to remove their shortcomings.
8. I kept a list of all the people who had harmed me and waited patiently for a chance to get even with them.
9. I got even with these people whenever possible except when to do so would get me in trouble, too.
10. I continued to take everyone’s inventory and when they were wrong, which was most of the time, I promptly made them admit it.
11. I sought through the concentration of my will power to get God, who didn’t understand me anyhow, to see that my ideas were best and that I had the power to carry them out.
12. Having maintained my emotional problems for twenty-five years with these steps, I can thoroughly recommend them to others who don’t want to lose their hard-earned status and wish to be left alone to practice neurosis in everything they do for the rest of the days of their lives.

Author Unknown

One will note the different focus between these 12 Step and the original 12 Steps. See Me, Myself and I

• See also
• 12 Rewards of Recovery
• Acceptance and Surrender
• A Baby Boomer’s Guide to the 12 Steps
• A Woman’s Way Through the Twelve Steps
• How does AA work? – Meetings, Meetings, Meetings

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Troubled social background of male steroid abusers

The aim of this study was to investigate the social background and current social situation of male abusers of anabolic-androgenic steroids (AAS).

We compared thirty-four AAS-abusing patients from an Addiction Centre with two groups, 18 users and 259 non-users of AAS from a public gym in Orebro, Sweden.

The study is based on semi-structured interviews and questionnaires.

Anabolic-androgenic steroid abusers displayed;

• histories of a troubled childhood
• current social disadvantage
• poor relationships with their parents
• physical or mental abuse.
• The anabolic-androgenic steroid group’s experiences from school were mostly negative, and included;
• concentration problems,
• boredom and
• learning difficulties.

Their current circumstance included;

• abuse of other drugs,
• battering of spouses and
• other criminality such as assault, illegal possession of weapons and theft.

In conclusion, this study shows that abusers of anabolic-androgenic steroids often have a troubled social background.

Research report; Kurt Skarberg & Ingemar Engstrom. Troubled social background of male anabolic-androgenic steroid abusers in treatment. Substance Abuse Treatment, Prevention, and Policy 2007, 2:20.

See also

• Alcoholic Family Roles
• Are there Patterns to Denial Behavior?
• Self-Help Books
• Inspirational Books
• The Guy in the Mirror

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Addicted people often feel handcuffed

Problems in controlling sexual behavior usually reveal themselves in four distinct stages:

Preoccupation: The person continually fantasizes about sexual prospects or situations. Constant sexual focus results in a high level of arousal which can trigger an episode of sexual “acting-out.”

Ritualization: A preferred sexual activity or situation is often stereotyped and repetitive, and may include a wide variety of activities intended to keep arousal at a high pitch, rather than being aimed at sexual release.

Compulsion: The person continues to engage in sexual activity despite negative consequences and a sincere desire to stop. A sex addict can feel as powerless as an alcoholic or drug addict over his or her addiction.

Despair: Sex addicts experience guilt or shame, often intensely, over their inability to control their behavior or feel remorse for pain they’ve caused others. The psychological fallout is equally crippling. Addicts may suffer other behavioral problems, particularly substance abuse and eating disorders.

Sex addicts also frequently suffer from intense depression and anxiety, often fueled by the fear of discovery. Suicide rates also tend to be higher among those with problems of sexual control.

The toll that compulsive sexuality takes is often seen in a loss of intimacy with loved ones, including problems in family functioning, communication, and marital sex life.

Ironically, the way out of sexual addiction often centers on renewing and strengthening the same relationships most affected by the problem.

• See also
• Sex and Love Addicts Anonymous
• Sexual Compulsive Anonymous
• S-Anon for partners and friends of sex addicts
• Say Yes to Your Sexual Healing
• Sex Addicts Anonymous

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Catherine Zeta-Jones in Legend of Zorro

This is a quote from a sufferer of Bulimia.

for the past week i keep binging..

ive been on a diet now since about 4 months or so and ive lost [edit]… i was doing really good and i hardly ever binged maybe once in the whole time.. all of a sudden in the past 2 weeks ive binged (and then purged) about 6 times.. i dont know whats wrong with me.. i feel so out of control.. i hate purging i know not even half the food comes up and then i feel guilty im really scared to gain weight again, i promise myself i wont do it the next day and then i do.. i just want control over my mind again but it seems liek i cant get control of it.

someone please help..

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Beyond Codependency

You’re learning to let go, to live your life free of the grip of someone else’s problems. And yet you find you’ve just started on the long journey of recovery.

Let Melody Beattie, author of the classic Codependent No More, help you along your way.

A guided tour past the pitfalls of recovery, Beyond Codependency is dedicated to those struggling to master the art of self-care.

It is a book about what to do once the pain has stopped and you’ve begun to suspect that you have a life to live. It is about what happens next.

In simple, straightforward terms, Beattie takes you into the territory beyond codependency, into the realm of recovery and relapse, family-of-origin work and relationships, surrender and spirituality.

With personal stories, hard-won insights, and activities, her book teaches the lessons of dealing with shame, growing in self-esteem, overcoming deprivation, and getting past fatal attractions long enough to find relationships that work.

“Melody Beattie is an American phenomenon . . . She connects with age-old quests for self-improvement and rebirth. . . [And she] understands being overboard, which helps her throw best-selling lifelines to those still adrift.”
Time

“[This book] goes beyond how we hurt to how we heal.”
Veronica Ray, author of Choosing Happiness

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Order today >> Beyond Codependency

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People in 12 Step Fellowships need to be aware of the different types of stress that can affect their recovery.

What are the different types of stress?

• Acute stress

Acute stress is the most common and most recognizable form of stress, the kind of sudden jolt in which you know exactly why you’re stressed: you were just in a car accident; the school nurse just called; a bear just ambled onto your campsite. Or it can be something scary but thrilling, such as a parachute jump. Along with obvious dangers and threats, common causes of acute stressors include noise, isolation, crowding, and hunger.

Normally, your body rests when these types of stressful events cease and your life gets back to normal. Because the effects are short-term, acute stress usually doesn’t cause severe or permanent damage to the body.

• Episodic acute stress

Some people endure acute stress frequently; their lives are chaotic, out of control, and they always seem to be facing multiple stressful situations. They’re always in a rush, always late, always taking on too many projects, handling too many demands. Unlike people for whom stress is a once-in-a-while spike, these folks are experiencing episodic acute stress.

According to the American Psychological Association, those prone to episodic acute stress include driven, hard-charging “Type A” personality types and worrywarts, always anxious about the next disaster they’re sure lurks around the corner. While the Type A tends to seem angry and hostile and the worrier more depressed, both are frequently over-aroused and tense, and both are susceptible to the physical manifestations of extended stress, including high blood pressure and heart disease.

Denial of Stress

If you’re prone to episodic acute stress, you may not know it or admit to it. You may be wedded to a life style that promotes stress. You may explain your frequent stress as temporary (“I just have a million things going on right now”), as integral to your work or home life (“Things are always crazy around here”), or as a part of your personality (“I have a lot of nervous energy, that’s all”). You may blame your frequent stress on other people or outside events, or you might view it as entirely normal and unexceptional. Unfortunately, people with episodic acute stress may find it so habitual that they resist changing their lifestyles until they suffer severe physical symptoms.

• Chronic stress

The American Psychological Association Help Center describes chronic stress as “unrelenting demands and pressures for seemingly interminable periods of time.”

Chronic stress is stress that wears you down day after day and year after year, with no visible escape. It grinds away at both mental and physical health, leading to breakdown and even death.

Common causes of chronic stress include:

• Poverty and financial worries
• Long-term unemployment
• Dysfunctional family relationships
• Caring for a chronically ill family member
• Feeling trapped in unhealthy relationships or career choices
• Living in an area besieged by war or violence
• Bullying or harassment
• Perfectionism

One of the most dangerous aspects of chronic stress is that people who suffer from it get used to it. They accept chronic stress as their lot in life, or they forget it’s there. Because chronic stress is based on long-term, often intractable situations, both the mental and physical symptoms of chronic stress can be difficult to treat.

• Traumatic stress

Severe stress reactions can result from a catastrophic event or intense experience such as a natural disaster, sexual assault, life-threatening accident, or participation in combat.

After the initial shock and emotional fallout, many trauma victims gradually begin to recover. But for some people, the psychological and physical symptoms triggered by the trauma don’t go away, the body doesn’t regain its equilibrium, and life doesn’t return to normal. This is a condition known as post-traumatic stress disorder (PTSD).

Common symptoms of PTSD include flashbacks or nightmares about the trauma, avoidance of places and things associated with the trauma, hypervigilance for signs of danger, chronic irritability and tension, and depression. PTSD is a serious disorder that requires professional intervention.

Treatment of Stress

If you are in a 12 Step Fellowship just doing the program will lessen much of the stress that may disturb your sobriety. The key tools are;

• Don’t drink, drug or control other people
• Go to plenty of meetings
• Talk to your sponsor and other members
• Read the literature
• Do the program
• Let go, let your Higher Power take over

Many people seek professional help. AA’s own survey suggests that 65% of members get counselling and medical help. And, procrastination will increase stress.

• See also
• 12 Steps and Post Traumatic Stress
• Acceptance and Surrender
• If You Want What We Have
• Of Course You’re Angry, Second Edition
• Masculine Grief is Different

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Demi Moore

This is a wonderful video about Self Injury from Face The Issue narrated by Demi Moore.

The following is a quote from a self injurer who trying to find freedom from their addiction.

I really sorta want to start cutting again.
the urges have come back…
i mean, i dont particularly enjoy passing out or being that weir lightheaded feeling,
and lord knows i dont need more scars,
but lately ive just really wanted to start cutting again,
and since i have refained from cutting i end up hurting myself in other ways, like almost breaking bones,
or when i have them, losing myself in an opiate fog and taking half a bottle of pills.
really, whats worse?
the drug or the cuts?
the cuts will heal in a week but the drugs just get worse and worse, and that lovely black pit is just becoming much more and more appealing.
nothing, feeling nothing sounds so great.
just not feeling.
why do i want to cut?
its just one more thing that wll hurt….
it makes no sense.
im just tearing myself apart.
for what reason?
i just dont even know.
why shouldn’t i cut?
how much worse off would i be???
what am i doing?
i just need to talk to someone.
i am just lost.

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Which one?

What are some questions to ask in choosing an alcohol and drug treatment program?

The US Substance Abuse and Mental Health Services Administration recommends asking the following questions when selecting a treatment program:

1. Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?
2. Is the program run by state-accredited, licensed and/or trained professionals?
3. Is the facility clean, organized and well-run?
4. Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?
5. Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate treatment services?
6. Is long-term aftercare support and/or guidance encouraged, provided and maintained?
7. Is there ongoing assessment of an individual’s treatment plan to ensure it meets changing needs?
8. Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?
9. Does the program encourage 12 Step Fellowship attendance?
10. Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual’s ability to function in the family/community?
11. Does the program offer medication as part of the treatment regimen, if appropriate?
12. Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?
13. Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual?

• See also
• 5 Alcoholism Myths
• Sober Companions
• The Dual Disorders Recovery Book
• A Woman’s Way Through the Twelve Steps
• The Guy in the Mirror

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Keep an eye on stress levels

What are the long-term effects of stress?

The stress response of the body is meant to protect and support us. When faced with a threat, whether it be to our physical safety or emotional equilibrium, the body’s defenses kick into high gear in a process known as the “fight or flight” response. The sympathetic nervous system pumps out adrenaline, preparing us for emergency action. Our heart rate and blood flow to the large muscles increase, the blood vessels under the skin constrict to prevent blood loss in case of injury, the pupils dilate so we can see better, and our blood sugar ramps up, giving us an energy boost.

Modern Stress is Mostly Psychological

The stress response is what helped our stone age ancestors survive, enhancing their ability to fight or flee from danger. But in the modern world, most stressors are psychological, rather than physical. Caring for a chronically-ill child or getting audited by the IRS qualify as stressful situations, but neither calls for either fight or flight. Unfortunately, our bodies don’t make this distinction. Like a caveman confronting a sabertooth tiger, we go into automatic overdrive, releasing the same hormones that enabled prehistoric humans to move and think faster, hit harder, see better, hear more acutely, and jump higher than they could only seconds earlier.

Repeated Stress Takes Heavy Toll

The problem with the stress response is that the more it is activated, the harder it is to shut off. Instead of leveling off once the crisis has passed, your stress hormones, heart rate, and blood pressure remain elevated. Extended or repeated activation of the stress response takes a heavy toll on the body. The physical wear and tear it causes includes damage to the cardiovascular system and immune system suppression.

Stress compromises your ability to fight off disease and infection, makes it difficult to conceive a baby, and stunts growth in children. It can even rewire the brain, leaving you more vulnerable to everyday pressures and mental health problems such as anxiety and depression.

And, of course, the stress of living with a debilitating disease or disorder just adds to the problem. As does recovering from disease such as alcoholism, addiction or codependency.

Recent research suggests that anywhere from two-thirds to 90 percent of illness is stress-related. The following is a list some of the health problems that can be caused or exacerbated by long-term stress:

Health Problems Linked to Stress

• Heart attack
• Hypertension
• Stroke
• Cancer
• Diabetes
• Depression
• Obesity
• Eating disorders
• Substance abuse
• Ulcers
• Irritable bowel syndrome
• Memory loss
• Autoimmune diseases (e.g. lupus)
• Insomnia
• Thyroid problems
• Infertility

Being in recovery can cause or multiply some of these problems. Mind, I said ‘can’ not ‘will’ cause problems. If you experience any additional health problems in recovery see your doctor. Procrastination never helps.

Try and keep stress to a minimum.

• See also
• Excess Stress Hurts Early Recovery
• HALT being Hungry, Angry, Lonely, Tired
• The Big Book Unplugged
• God Grant Me The Laughter
• One Day at a Time Slogan

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