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The Pathways to Sobriety Workbook
By William Fleeman
Hunter House Inc., PublishersCopyright © 2004 William Fleeman
All right reserved.
Chapter OneThe Basics
This chapter will provide you with some basic information about alcohol and other drugs and will help you begin to understand the nature of addiction and recovery from addiction.
Why People Use Alcohol and Other Drugs
People use alcohol or other drugs to change their emotional state-that is, to change how they feel. It's as simple as that. People use various drugs such as alcohol, cocaine, heroin, caffeine, Ecstasy, and nicotine in order to change painful feelings such as anxiety or depression into more pleasurable feelings such as relaxation or joy. Sometimes people use chemicals to increase the intensity of pleasurable feelings, such as excitement or confidence, that they are already experiencing. The reason that people continue to use alcohol or other drugs to change how they feel is because it works, at least for a while.
While it is true that people use alcohol or other drugs to change how they feel-even if only to feel more relaxed or more included in a social situation-it is also true that not all people become addicted. In fact, in the case of alcohol, some people seem to enjoy the taste as much as anything else.
History of Alcohol and Other Drug Use
People have been using alcohol or other drugs to alter their emotional state for at least five thousand years. There are written accounts of the use and abuse of alcohol from as early as 3000 B.C. The chewable form of cocaine was probably in use in South America at least two thousand years ago. People in Asia have been using opium for several thousand years.
Alcohol, the most widely used and abused drug of all, may have been in use in prehistoric times. Imagine a Neanderthal hunter shambling dejectedly along a path on the way home from an unsuccessful hunt, dragging the end of his stone-tipped spear in the dust. He not only feels like a failure, but also it is a very hot day under a boiling sun and so he feels thirsty as well. He notices a shallow pool of reddish bubbling liquid off to one side of the path. The liquid is made up of the fermenting juices of common berries that have fallen from a bush and lain in the sun for several days. The hunter recognizes the berry bush and recalls eating the red berries in the past without experiencing pain. Stopping to investigate, he kneels down and sniffs the reddish liquid. Then he sticks a finger into the mash and tastes it. Cupping his hand, he scoops up some of the liquid and drinks it down. "Not bad," he grunts, experiencing a slight buzz. He drinks more. "Not bad at all," he grunts again, slurring his words slightly. Getting down on his hands and knees, he makes like a human wet-vac and sucks up the entire alcohol-laden pool. He becomes the very first person in history to get drunk, and he then proceeds to suffer the world's first hangover the next day.
important to be on the lookout for signs and symptoms that may indicate a need to seek immediate medical attention. They include: excessive nervousness, sweats, tremors or shakes, rapid or irregular pulse, shortness of breath or irregular breathing, crying spells, laughing spells, rapid-fire speech, slow or slurred speech, unsteady gait, slow reflexes, depression, anxiety.
History of Addiction Counseling
In the United States and most other countries prior to about 1970, what later became known as addiction counseling was done by clergy and by volunteers who were members of Alcoholics Anonymous. Most physicians, psychologists, and psychiatrists would not treat alcoholism or drug addiction. They treated the medical complications that alcoholics and drug addicts invariably suffered, but they usually would not attempt to treat the disorder itself. In fact, the medical and psychiatric fields did not consider alcoholism and drug addiction, in themselves, to be diseases. Many of the top experts in the medical and psychiatric professions believed that alcoholism and drug addiction were moral afflictions. After treating them for medical complications, doctors often sent their alcoholic and drug-addicted patients to ministers, rabbis, or priests. Sometimes alcoholics ended up on psychiatric hospital back wards and died there. Their diagnosis: dipsomania. The dictionary defines dipsomania as an irresistible craving for intoxicants.
Recovery Models: Abstinence vs. Controlled Use
There are two very different recovery models: abstinence models and controlled-use models. Abstinence models maintain that recovery from addiction to alcohol or other drugs requires the addicted person to abstain completely. Controlled-use models suggest that the addicted person can learn how to use alcohol or other drugs in moderation and avoid consequences.
Alcoholics Anonymous (AA), which began in Akron, Ohio, in 1935 and was cofounded by William Wilson, a New York City stockbroker, and Robert Smith, an Akron physician, uses the abstinence model. Both Wilson and Smith were addicted to alcohol. Dr. Smith was said to have been addicted to barbiturates as well.
AA suggests that the alcoholic follow twelve specific steps in order to get sober and stay sober. For that reason, AA is often called a twelve-step recovery program. The steps ask the alcoholic to take responsibility for his or her addiction and for the consequences of his or her addiction; to turn to a "higher power" for strength, support, and guidance; and to make amends to people he or she may have harmed.
Largely because of the influence of Wilson and Smith and of AA as a whole, opinions about alcoholism and addiction began to change over the decades. Eventually (around 1970), the medical profession officially recognized alcoholism as a disease. When that happened, psychologists, psychiatrists, and other professional caregivers began to more actively treat addicted persons. Ultimately, a whole new field opened up: chemical-dependency counseling.
Narcotics Anonymous (NA) was started around 1955 as a program specifically for people recovering from addiction to drugs other than alcohol. NA uses essentially the same format as AA, including a focus on the twelve steps. Like AA it encourages total abstinence from the use of drugs, and like AA it enjoys a very high success rate.
There are those who believe that people who are addicted to alcohol can learn how to use alcohol responsibly, whatever that means. It may be true that some people who are addicted to alcohol or other drugs can somehow learn to control their alcohol or other drug use. However, for the "true" alcohol addict or drug addict, this is a potentially dangerous idea. One of the symptoms of addiction is loss of control. This means the addicted person is at times unable to stop after just one or two drinks or after one or two puffs on the crack pipe. Pathways to Sobriety believes that alcohol addicts or drug addicts who use the controlled-use model are likely to fail. They are more likely than not to return eventually to abusive use of alcohol or other drugs. The consequences for them as well as for their families could be lethal. Although people who use the abstinence model sometimes also relapse, Pathways to Sobriety believes that people who use the abstinence model are less likely to relapse into full-blown addiction.
Message from Jack
My name is Jack. I'm recovering from alcohol addiction. I loved the alcohol high and really didn't want to stop using alcohol to change how I feel. I tried AA but rejected that program because I'd have had to quit drinking entirely. I thought I could learn to control my intake so that I could still cop a buzz now and then but avoid getting into trouble. I read some books about how to control one's use of alcohol. I even found a counselor who said he could help me learn how to drink safely and responsibly. I did alright-at first. After about three months I was able to stop after just a few and could choose where and when to drink. I limited myself to three drinks in an evening if I went out and drove my car. I limited myself to four or five if I stayed home.
Then one night I went out to my favorite bar to have a couple of drinks with my friends. It was one of those times when I was having a lot of fun and didn't notice the effects of the alcohol. I ended up having about six drinks, twice the number I'd set as my limit. When I left the place around 10:00 P.M., I was feeling a little high but not drunk. I got home fine. Safe and sound at home, I decided to have another drink before going to bed. I ended up finishing the rest of a bottle of scotch that I'd had in the cupboard for a couple of months. The scotch went down easy, and I drank the equivalent of about six drinks. After finishing the scotch, I felt like having more. By then I was definitely impaired. I checked my watch. It said 11:35 P.M. The liquor store was only ten minutes away. I could easily make it without speeding. I felt totally confident. I walked from the kitchen cupboard to the kitchen table on the other side of the room. No problem. Straight as an arrow.
I went out and got into my car and headed for the liquor store. A few minutes later, I started feeling the effects of the scotch more than I wanted to. My eyesight got a little blurry. I could also tell that my reflexes weren't the best. About a block from the liquor store, I came to a stoplight. I stopped at the white line and waited. Looking to my left, I saw a car approaching from the cross street and saw it slow down. The light changed and I entered the intersection at a prudent speed. All of a sudden, the car on my left that I thought had stopped came barreling through the red light and smashed into my left front fender. I saw the car at the last second but it was too late. Drunk or sober, I couldn't have avoided a collision. There were two people in the other car, the driver and someone in the passenger seat. Neither of them was hurt. Nor was I.
The driver of the other car had called the police on his cell phone even before he got out of the car, and before I knew it the police were there. The cop Breathalyzed both of us. The other guy had been drinking but blew under the limit. I blew one point over. The other guy had run a red light and was clearly in the wrong. But there were no witnesses, other than me and the two guys in the other car. Naturally, the driver of the other car told the cops that I was the one who ran the red light, and the passenger backed up the driver's story. I'd had a DWI a few years before, so guess who got the ticket? Guess who lost his license? And guess who doesn't use the controlled-drinking model anymore?
Pathways to Sobriety
Like AA and NA, Pathways to Sobriety uses the abstinence model. But Pathways to Sobriety is not a twelve-step program. Pathways to Sobriety groups are structured in a way that is similar to the way twelve-step groups are structured. Pathways to Sobriety groups are facilitated by peer volunteers, charge no fees, and are open-ended and ongoing. However, Pathways to Sobriety groups do not use the twelve steps as guides for recovery. Instead, Pathways to Sobriety uses a set of eight principles.
It is assumed that you have made a decision to stop using alcohol or other nonprescribed drugs, and to learn how to live happily clean and sober. Once you start on the road to recovery, from then on the name of the game is relapse prevention. In fact, you could say that the rest of this workbook is devoted to that single, extremely important end-relapse prevention.
If you abuse or are addicted to alcohol or other drugs, you have probably spent many years conditioning yourself to be a drinking or drugging machine. This conditioning process is now a permanent part of your subconscious mind. Your addiction program is hardwired into your subconscious and will remain potentially very powerful. What you need to do as a person in recovery from addiction is to saturate your subconscious with new material through a conscious application of the tools of recovery. The Pathways to Sobriety Workbook aims to help you do just that.
Chapter TwoBill's Story
Writing down my story was an important part of my recovery from addiction to alcohol and other drugs. Writing it helped me understand why I became addicted. It helped motivate me to stop drinking and using drugs and helped me find out how to stop. Writing my story was an important part of my self-assessment.
In addition to my addiction to alcohol and other drugs, I had another serious problem. I used anger like a drug as well. In my book The Pathways to Peace Anger Management Workbook, my story focused on my addiction to anger and rage. My story here focuses on my addiction to alcohol and other drugs. But the reader should understand that my addiction to alcohol and other drugs is closely related to my addiction to anger. I cannot talk about one without mentioning the other. Maybe it is that way for you too.
When I wrote my story in The Pathways to Peace Anger Management Workbook, I wrote down only the bare essentials. It was brief, only seven or eight pages. The story you are about to read here is a much more detailed and much longer version. I call it the whole story. My hope is that you will relate at a deep, personal level.
Exercises have been included after each main part of my story to encourage you to pause and reflect so you can see whether any of the events described in my story connect to similar events in your personal history.
A Special Note
In order to understand yourself as deeply as possible, and to heal as completely as possible from your addiction to alcohol or other drugs, you need to write down your story. Appendix A, located in the back of the workbook, has been set aside for you to write down your story. It is located in the back of the book because you will need time to think and reflect as you work on this very important part of your recovery from addiction to alcohol or other drugs. You are encouraged to begin work on your story as soon as you feel comfortable doing so, but you are not expected to finish writing down your story before you finish the rest of this workbook. There may be parts of your story that you will not want to write down or even think about before you have been clean and sober for a period of time. You may want to have the support of a professional counselor when you decide to write down some of the more emotionally charged events of your life. You can skip over these sensitive areas at first, but as you grow stronger you are encouraged to write down everything. Of course, you will not want to write down anything if making a record of it on paper would injure yourself or other people. Use discretion, but don't hold back unnecessarily.
Excerpted from The Pathways to Sobriety Workbook by William Fleeman Copyright © 2004 by William Fleeman. Excerpted by permission.
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