Tag Archives: alcoholism

“What to do with a client that may have addiction issues” Part 2 – Cognitive Distortions, Stages of Change and ACE Assessments

Cognitive Distortions

As I interview the client, I keep in mind their language, way of talking and their perceptions. I listen for Cognitive Distortions in their conversations. Dr David Burns, author of “Feeling Good” has a list of Cognitive Distortions that comes into service here, as it can identify certain key phrases that reveal the cognitive distortions that are characteristic of an addict . I am sure you have heard these types of cognitive distortions in past interviews

1) They didn’t show up on time, they’re completely unreliable! This is an example of All or Nothing thinking, a cognitive distortion
2) I’ll never get that promotion/ My boss always tries to swindle me out of my commission. This is an example of Over-generalization
3) I forgot to send that email! My boss won’t ever trust me again, then I won’t get that raise, we will loose the house to foreclosure and my wife will leave me. This is an example of Catastrophizing, which is seeing things as dramatically more or less important than they actually are.

Identifying the Stage of Change

My next series of assessment questions include the Annis, Schober & Kelly interview questions, to identify the stage of change the client is in . This series of interview questions are drawn from the Identifying the Stage of Change research by James Prochaska, John Norcross and Carlo DiClemente. There are six questions in this interview and the questions start out very simply:

1. Did you drink during the last 30 days? YES or NO
2. Are you considering quitting or reducing drinking in the next 30 days? YES or NO
3. Did you knowingly attempt at least once, to quit or reduce your drinking during in the past 30 days? YES or NO

At this point in my assessment work, I have to decide whether I can help this person or not. I call the Annis, Schober & Kelly assessment the “knowing when to hold them or knowing when to fold them” assessment. If in completing this assessment, the coaching client does not present that they are in the Preparation Stage or the Contemplation Stage of change, I cannot help them. I have to regretfully say I cannot help them and why.

Adverse Childhood Experiences

The last series of questions are from the ACE survey (Adverse Childhood Experiences) which are highly personal questions . In the executive coaching world these are not questions an executive coach would ever ask, but for a recovery coach, these are important questions. However, I still have to tread very lightly on these queries. I preface the questions with a warning that I will be getting very ‘close’ to the client with the next series of queries, and if he/she chooses not to continue with answering these questions, we can move on.
Some examples are:

1. Did a parent or other adult in the household swear at you, insult you, put you down or humiliate you?
2. Did a parent or other adult in the household push, grab, slap, or throw something at you?
3. Did you often or very often feel that no one in your family looked out for each other, no one feels close to each other, or no one supports each other?

 

The ACE questionnaire is important in identifying behavioral addictions, primarily eating disorders or compulsive sexual behaviors, so I use it specifically for queries that may identify these addictions.

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Why Everyone in Recovery Should be Trauma Informed: A Chance to Heal – Part Four

Guest Post By: Dan Griffin of Griffin Recovery Enterprises | dan @ dangriffin.com | http://dangriffin.com | 612-701-5842 |“Helping Men Recover From Addiction and Experience the Limitless Possibilities of Recovery. If you are interested in learning more about men, addiction, trauma and recovery—for yourself or for a loved one—I encourage you to check out Dan’s book “A Man’s Way Through the Twelve Steps”. This is the first trauma-informed book of its kind that focuses specifically on men’s unique challenges, needs and possibilities in recovery.

If there is one message I truly wish to impart to anyone who has been reading this series, it is this: you can heal from the effects of trauma, even devastating trauma, and there is hope for you and/or the person you love. And so, it is important that we do all we can to recognize the effect of trauma on our lives and the lives of our loved ones.
The topic of men and trauma has been under-discussed and even ignored for far too long. Too often we have heard about men’s natural proclivity for aggression and violence as though we are automatons powerless against the testosterone coursing through our bodies. While there is obviously some biological truth to that idea, we would be fooling ourselves to think that is the whole story.
To summarize these four articles, the questions that need to be addressed are:
• How do we talk about men’s violence and their experience of trauma in a meaningful way?
• What do we need to do to have a positive effect on men changing their violent and abusive behavior?
• How can we help men see their own pain and suffering, and then create places where they can feel safe enough to talk about these things?
The truth is, you absolutely cannot talk about men’s violence without talking about men’s trauma. To even attempt to do so is irresponsible. Yet, there has been an underlying philosophy in how we have assessed and treated men, a cynical judgment borne of resignation and ignorance coming from both men and women that shrugs its shoulders and says, “That’s just how men are.” And men’s voices have been too quiet—or even absent—from these conversations. Out of guilt, apathy, ignorance, entitlement and arrogance, we have contributed to a picture that is woefully incomplete—at best it is two hands on the proverbial elephant.
We now know based upon brain imaging techniques what many people have understood intuitively: that trauma literally gets locked in our brains and in our bodies. We have many tools available to us to treat that process, whether it is Eye Movement Desensitization and Reprocessing (EMDR) or using yoga or music therapy to help people get into their bodies and out of their heads. One of the breakthroughs in the field of trauma is a fundamental shift in our approach to those who have suffered, and that is moving from a place of asking accusingly, “What’s wrong with you?” to a place of asking compassionately, “What happened to you?” This is a shift that we should incorporate into our everyday lives and interactions.
There is no question that this is a difficult topic to address. It can be very scary for men to talk about abuse and trauma; most of us will not even use the word “fear,” certainly not at first. As I have been saying for years: it is hard for us as men to talk about trauma without feeling as though we are somehow compromising our masculinity. Keeping all of our pain tucked away deep inside, many of us go through this world acting as tornadoes in others’ lives, leaving a path of destruction everywhere we go. Our tendency as men is to externalize the effects of the trauma—which, simply stated, means we act out those effects with other people often directly in our line of fire. Then, perhaps worst of all, people react to our behavior and we can only see the injustice of our behavior, not what we have done to help cause it. One of the hardest aspects of trauma is that you literally feel crazy—like Jekyll and Hyde or as if you have been possessed by some demon exhibiting behaviors and committing acts that horrify you and cause great personal shame. There are those men who experience childhood trauma and they grow up not to be abusers but abused—by their partners, male and female! There is a small group of men and women helping to increase our society’s awareness of men who are abused. That group of men coming forward are very courageous and have talked about the incredible shame and denial they have felt as a result of experiencing abuse in their most intimate relationships, especially from women.
Do you think you might be living with untreated trauma? If so, here are some questions taken directly from pages 233-234 of my book, A Man’s Way through the Twelve Steps, the first trauma-informed book for men in recovery from all addictions, that can help you find an answer:
• Do you yell at other people or put them down in mean and hurtful ways?
• Do you find yourself mistreating your partner and sometimes feeling as if you are possessed or two different people?
• When you feel close to someone, do you often find yourself shutting down or becoming full of rage toward him or her?
• Do you mock your partner or become very uncomfortable when he or she cries or expresses vulnerability?
• When you feel sad or hurt, do you often turn to anger or rage or isolate in depression?
• Do you overreact to conflict with extreme engagement or avoidance?
• Are you easily startled?
• Do you find yourself struggling with violent thoughts on a regular basis?
• Do you push others away with sarcasm, ridicule, or abuse when they are getting too close?
• Do you push away people you love and care about by using anger to protect yourself from being hurt?
• Do you have visions or fantasies of hurting those you love?
If you answered yes to any of these questions, you should consider getting professional help if only to explore any questions you have or to get more information. If you think you may be suffering from the effects of trauma, go see a professional who is trained in treating trauma.
Sometimes the damage is painfully obvious and sometimes it is subtle, hidden, and insidious—living behind the doors of suburban homes on golf courses. Behind the painted-on public smiles of families struggling to keep it together. In the menacing sneer of the criminal—the last one for whom you want to feel compassion—who made a decision when crying himself to sleep one more time, that he would never be hurt again. Or the man who finds it impossible to remain in a relationship and is afraid he is going to spend the rest of his life alone. Or the young bully beating the shit out of the boy he is sure is gay. The list goes on, ad infinitum. I have no doubt that most of the violence, aggression, and rage we see in this world comes from unrecognized and untreated trauma. That violence is unacceptable and inexcusable, but it won’t end until we see it clearly and address it with both compassion and accountability.
Part of what happens with trauma is that we write a story—or narrative in therapeutic parlance —about ourselves, and we live in that story as if it were true. We forget that we made it up. We forget that we can change the story at any time. In fact, a core part of trauma therapy is the re-framing of the narrative. Of course, you can rewrite it all you want, but there is deeper work to be done. For me , it required gut-wrenching, curled-in-a-ball, give-anything-to-have-this demon-exorcised emotional work. As the saying goes: There is no way out but through. There is certainly nothing fair about it all. The sooner you let go of that idea of life needing to be fair, the easier it will be for you to find peace through all of the rubbish, all of those distorted beliefs and behavior patterns.
By doing the personal work, I have been able to put all of my past experiences into perspective and have been freed to create a new narrative for my life. I can acknowledge that much of my upbringing was far from healthy, safe or loving. I can also say honestly that I understand today that my parents did the best they could, and that so much—if not all—of their behavior was never personal. I was often caught in the line of fire but rarely ever the actual target. I can also feel immense gratitude for the path my life has taken— especially after having spent the past week working with prisoners sentenced to life in a maximum security prison. (But for the Grace of God there go I.) I have even been able to find fleeting moments of gratitude for all the pain I have experienced in my life because it has made me the man I am today. My narrative has changed dramatically, especially in the past seven years. Again, you cannot will this to happen—you have to dig down deep, grab the strongest hands you can find to help you, and do the work. Over and over. But it is worth it. There is no way out but through and on the other end is a life you cannot even imagine. You will know a new freedom and a new peace.
I have been getting a lot of people thanking me for writing these articles and speaking openly about these issues. I hope it generates a lot more men writing about the topic from as many perspectives as possible. This is where we have to start: by eradicating the stigma of men talking about abuse, while making sure we also connect it to men’s violence and acknowledging when we have been perpetrators of abuse. In addition to Tyler Perry and the Oprah “200 Men” show, Sugar Ray Leonard may have done as much in that vein with his recent autobiography. More male voices are starting to break the silence. If you are fortunate—or determined enough—you will find the love and support you need. Nothing kills more men than the foolish belief that we have to do everything on our own, though sadly we come by it very honestly. That mentality permeates so much of our experience. You will find your own path to healing, but not if you do not look for it and take the first steps. The most important advice I can give is to take the journey; you will never regret it, though there could very well be times when you are in such pain you wonder if it is worth it. I can say without hesitation that it is, and it will always be. That is a Promise.

If you are interested in learning more about men, addiction, trauma and recovery—for yourself or for a loved one—I encourage you to check out A Man’s Way Through the Twelve Steps. This is the first trauma-informed book of its kind that focuses specifically on men’s unique challenges, needs and possibilities in recovery. Sign up for my free e-newsletter, and you will also receive a free excerpt from A Man’s Way today.

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Why Everyone In Recovery Should Be Trauma Informed – For Women And Children’s Sake: Part 3

Guest Post By: Dan Griffin of Griffin Recovery Enterprises | dan@dangriffin.com | http://www.dangriffin.com | 612-701-5842 “Helping Men Recover From Addiction and Experience the Limitless Possibilities of Recovery.
My passion in looking at men and trauma comes primarily from my personal experience as a young boy, first growing up in a violent alcoholic home and then having to deal with the impact of that trauma long into my thirties — and long into my sobriety. I still have vivid memories sitting on the top stair outside of my parents’ bedroom, hearing my mother screaming and crying as I was trying to get up the nerve to open the door or bang on it, once they/he had finally gotten smart enough to lock it. Or crying myself to sleep through the only slightly muffled sound of my parents yelling, cursing, and belittling each other — only to pretend like nothing had happened the next day. Or my Dad grabbing me by my leg as I was trying to get away from him, pulling me down the stairs and then proceeding to hit me. I could go on.
Believe it or not, I had a lot of confusion as to whether what I had grown up in was actually violent. It was only until I got into relationships with people who did know the difference that I began to see that how I grew up was far from normal — even though, sadly, far too many children experience the same thing and even worse. With that in mind, it would be completely irresponsible of me not to talk about the effect that men’s trauma has on women and children. While compassion for men is essential, we have to be careful that compassion does not become enabling or minimizing of the horrific violence that women and children are enduring on a daily basis because of men acting out due to unaddressed trauma.
Here are some sobering statistics that are important to always keep in mind when we are talking about men and trauma:
* Approximately 1.5 million women are raped or physically assaulted by an intimate partner each year in the United States. Because many are victimized more than once, approximately 4.8 million intimate-partner rapes and physical assaults against women are committed annually (Bureau of Justice Statistics, 2000).
* Women aged sixteen to twenty-four experience the highest per capita rates of intimate violence (19.6 victimizations per 1,000 women) (Bureau of Justice Statistics, 2003; National Coalition Against Domestic Violence, 2009).
* One in every four women will experience domestic violence in her lifetime. Eighty-five percent of domestic violence victims are women. Most cases are never reported to the police. (National Coalition Against Domestic Violence, 2009)
* In 2007, approximately 5.8 million children were involved in an estimated 3.2 million child abuse reports and allegations. [Most cases are never reported to the police.] (National Child Abuse Statistics, 2010)
* About 30% of abused and neglected children will later abuse their own children, continuing the horrible cycle of abuse. (National Child Abuse Statistics, 2010) [My uneducated guess is that this number is actually much higher when we think about how much violence and abuse still lives in the shadows.]
The first thing that needed to happen in order for me to better see and understand my behavior was that I had to realize that violence was so much more than what I thought it was. I was often so focused on my internal experience that I did not look at my external behavior. “How can I be scaring anyone when I feel so afraid?” I would say, angrily yelling, after having been confronted. Or maybe I would laugh that patronizing laugh that we as men can have that essentially says: “Stop being such a f’in baby” (echoed from the mouths of so many who we had followed into manhood). Like my alcoholism, so long as I maintained a fixed definition of violence then it meant that I was not violent. But, in fairness, I was not shown what love and peace really looked like — or better, felt like. I did not understand what it really meant to feel safe. I did not realize that punching a wall was an act of violence — I thought it was avoiding violence!
Here are some other examples of violence, taken from page 240 of my book, A Man’s Way through the Twelve Steps:
* Raising your voice at your partner in an effort to intimidate or silence.
* Using your physical body to intimidate in any way by size and strength alone. Most men are intimidating to women and children, and few men understand this.
* Slamming doors.
* Threatening harm to yourself or to your partner.
* Punching or kicking a wall or door with someone else in the room.
* Taking car keys or doing anything else to prevent your partner from leaving your presence or your home, or doing any other act that prevents your partner from seeking safety.
* Chasing your partner as he or she tries to leave or escape from you and your threatening behavior.
In our trauma-informed curriculum, Helping Men Recover, we make one thing clear throughout — even strongly encouraging clinicians to put this message up in their offices and their group rooms: Whatever happened to you as a child — no matter what you did — was not your fault; and, whatever you do or have done as an adult that has harmed another — no matter what someone else has done — it is your responsibility and it needs to stop.
The last thing I ever wanted to do was continue the cycle of abuse. I hate violence, have a pure heart, and never wanted to see anyone in pain. Yet, I found the same words coming out of my mouth with the same anger and violence from which I used to cower. I behaved in ways towards others that were exactly the same kind of behavior that still had me afraid of being in the dark as a goddamn grown man! While it is hard to write these words, I feel as though I must, because until we men begin to truly own our behavior and call it what it really is nothing is going to change. We must shine an honest and compassionate light on this topic. Nobody wants to be an addict; to become that which so many of us swore we would never be. And, maybe that is the same fear that gets in the way for so many of us men in acknowledging the impact of abuse on our lives: the fear of being our fathers (or whoever it was that abused us.) Of course, with all the bullshit we have about being a man in our society, a man acknowledging the pain of abuse sometimes feels comparable to admitting he is not a man at all. Hell, there is still a part of me that feels like a [fill in the epithet] for writing these words. There is no question that at the heart of the vast majority of abuse is a stagnant well of toxic shame corroding the spirits of some very good men.
I could truly write another book on this topic alone but I am only able to hit the tip of the iceberg here. The reality is that it is not unreasonable to assume that most men, especially those of us in recovery from any addiction, have had some experience of trauma. I believe this should be an expectation, not considered an exception as it often is now. But nothing guarantees that sobriety will stop a man’s violence or heal the trauma destroying so many people’s lives. Helping a man to understand that his experience was indeed traumatic is not easy. The way we still raise boys to be men overlaps far too much with violence and abuse, which leads many of us to confuse that kind of mentality and behavior with Love. With that in mind, we should also assume that most men in recovery do not have a full understanding of violence, and so it is incumbent upon those of us who have come to a different understanding to share it, and to even take an unwavering stand against violence against women and children — and men! One of the greatest ways for me to heal has been the commitment to peace and safety I have made to my wife and my daughter — and even our little Shih Tzu, Haley. The more I am able to be the man I always hoped to be, the more I can see that is who I have always been.

 

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