“A substance use disorder is a medical illness characterized by clinically significant impairments in health, social function, and voluntary control over substance use.”
– Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health, November, 2016, Page 4-1

“Addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”
– National Institute on Drug Abuse (NIDA), a division of the National Institutes of Health (NIH), 2014

Do no harm.

Use evidence-based treatment modalities.

I define evidence-based treatment as what research reports works for most people, most of the time, better than other treatments, and better than no treatment. Specifically, that means the treatment is supported by numerous, peer-reviewed scientific experiments with rigorous methods that include control groups, randomization of subjects to experimental conditions, and bias-free samples, with statistically significant results. Some treatments that are evidence-based to work for groups may not be helpful to a particular individual, however. It is an imperative that counselors and individuals continually monitor an individual’s condition and progress while engaged in treatment.

I contrast research data – the evidence resulting from research experiments – with “anecdotal data.” I define anecdotal data as an individual’s personal experience. Data from a sample size of one does not provide sufficient information from which a generalization can be made about a group or population. Principles believed to account for outcomes from inspirational individual stories, practitioner wisdom, or theories based on logic, cannot be safely applied to others without first subjecting those principles to rigorous research.

I have relentlessly studied what evidence-based substance use disorder treatment should be. An outline of my findings is here.

Provide the caliber of therapy and treatment you would want for your own child.

Champion the power and resilience of the individual.

Jettison all identity-compromising, stigma-perpetuating words and phrases from one’s vocabulary: addict, alcoholic, substance abuse, get clean, dirty urine, hit bottom, tough love, codependency, enabling.

Practice “love love,” not”tough love.”

If you’re in recovery from addiction and visiting the Blacksburg, Virginia area…

Here’s a list of local support groups with dates, times and locations. (If you need urgent support, here’s a list of our local substance use disorder resources. If you need emergency support, please dial 911 or head to the nearest emergency room. In Blacksburg, that’s here.)

For exercise, the easiest, drop-in place to go with the most options is The Weight Club.

The town pool, Blacksburg Aquatic Center, offers daily swimming passes.

Recovery-friendly church services are offered at edges. edges is affiliated with the local Methodist church. Anyone of any faith – or of uncertain, little, or no faith – is welcomed.

The Blacksburg Meditation Group meets every Sunday from 7:30 – 8:30 PM.

Interesting, pleasant, quirky events are held at the library.

NextThreeDays offers a list of current things to do in Blacksburg (incluces many menu specials from local restaurants). Some local events are included in the Roanoke calendar of the Roanoke Times.

In case of rain or snow, try a supportive self-care practice.

On your own, try a sensory tour of Blacksburg.

Taste

If you like coffee, something interesting to do might be to taste all the coffees in the local coffee shops and discover your preference. (This is a dialectical behavior therapy-informed activity because it engages the senses, focuses attention, and asks for discernment. DBT is an increasingly evidence-based therapy for supporting abstinence for people with substance use disorders.) Several shops offer locally-roasted beans.

• Here’s a narrative about local coffee shops.
• Here’s a list of local coffee shops.
• This local roaster doesn’t have its own shop but here’s where to find their coffee.

If pizza is more to your taste, there are several, one-of-a-kind pizza shops to try.

Sight

• Blacksburg’s 16 Squares historic district
• Hikes
• Our Daily Bread’s French pastry display

Smell

• Hahn Horticulture Garden
• Eats
• Carol Lee Donuts

Touch

• Montgomery County Animal Shelter (nearby in Christiansburg)
• Joann Fabric (nearby in Christiansburg)

Sounds

• Water flow and water fowl at Virginia Tech Duckpond
• Stream and waterfall at Hahn Horticulture Garden
• Hushed voices at the library
• Listen for the takeoffs at the Virginia Tech Montgomery Executive Airport and see if you can begin to identify the sound of the plane with its type
• Noteworthy background music at Goodwill (nearby Christiansburg) and Subway on University City Boulevard

Kinesthetic

• Paint n’ Fun

For more ideas, Melody Warnick features Blacksburg, Virginia in her book This is Where You Belong: The Art and Science of Loving the Place You Live.

If you would like or need a support person in the Blacksburg, Virginia area, feel free to call or text me, Anne Giles, 540-808-6334.

Enjoy your visit!

Photo: Z. Kelly Queijo, founder of Blacksburg Lodging and Smart College Visit.

Want to join me in a month off from alcohol?

If so, we’ll be part of growing movement started in the United Kingdom. According to the Dry January organization, over 2 million people participated last year.

In its 12/2/15 article, The Fix cited early research on the health benefits of a month off from alcohol and interviewed Andrew who takes January off from drinking each year. According to The Fix, “Andrew says the main benefits for him were weight loss and better focus. He found he slept better and awoke refreshed. And after all, he says, it’s only for a month.”

In 2014, NPR reported, “Fourteen healthy New Scientist employees filled out lifestyle questionnaires, underwent ultrasounds and gave blood samples. Then, 10 of them gave up alcohol for five weeks, while four of them continued drinking normally.” NPR discusses the results here. NPR states that liver specialist “[Dr. James] Ferguson warns that a dry January could trigger the same sort of negative boomerang effect as do restrictive diets: First you abstain, then you binge to make up for it. He questions whether a dry January leads to a wetter-than-normal February.” Dry January reports, “8% of participants carry on not drinking after January and two-thirds of people who take part say they are drinking less, six months later.” So it’s hard to predict for each individual what the results might be.

Chris Raine has developed a software platform and mobile apps for people who want to change their drinking, Hello Sunday Morning. The Fix interviewed Raine on 12/18/15. I haven’t tested the software but Raine’s statements seem reasonable to contemplate during a Dry January: “We believe that changing your relationship with alcohol is about more than whether you drink or not, and how much you consume when you do. Rather, it is about understanding why you are drinking in the first place.” Jill Stark shares fascinating revelations resulting from her period of abstinence.

In Do You Think I Have a Drinking Problem?, I wrote earlier this year of my relief that people feel comfortable and free to ask me about drinking, both for themselves and for loved ones. “How do you feel when you don’t drink?” is a key question to ask. Taking some time off from drinking can help provide the answer.

I was abstinent from alcohol for 3 years on December 28, 2015. I am abstinent today, I will join you in abstinence during Dry January, but I’ll keep going in February and March and… I have an acute problem with alcohol and have to abstain completely, forever, in order to treat that problem. O, how I wish you do not have what I have! Regardless, you’re welcome to abstain with me in January and continue with me or not, your choice.

I absolutely loved champagne. If you’re still drinking, savor just a sip for me on New Year’s Eve. Then on January 1, let’s get abstinent and see what happens.

Important: If you have any physical sensations when you delay or do without alcohol, that, unfortunately, indicates a problem. See a health care provider ASAP. And, frankly, if I could begin my recovery from addiction to alcohol over again, I would see my primary care physician before I even stopped. Addiction to alcohol and other substances is a medical illness and requires medical care. Shame and stigma made me go “cold turkey” in 2012 and lack of treatment opened the door to a universe of suffering for which I can barely find words. It did not have to be that hard. However, with people now speaking out about recovery from addiction, 2016 is the absolute best year ever to try dry.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Coach Sarah Beth Jones and I had an email correspondence which I am sharing with her permission, a few words edited for clarity.

Anne to Sarah Beth:

[Thoughts about outline for memoir mentioned in this post.]

Sarah Beth to Anne:

Absolutely chilling, Anne! There is power absolutely radiating from this outline. So raw, so real, so useful.

What’s your next step?

Anne to Sarah Beth:

May I have your permission to share our correspondence?

I have been asked why I have a coach for writing this book. I’m an excellent writer, I’m a counselor, I could coach myself. I’m organized, driven, can both envision projects and execute them. Why a coach?

Because I go in, and I come out, and I look around and feel sort of vacant. What did I just do? What did it say, where did it go? Did it *work* on some level? And given that I don’t know what I just did or where I am, where do I go next?

During the time we’ve worked together, I’ve kept waiting for the proverbial other shoe to drop – for you to be judgmental and directive like so many people to whom I have turned over my direction for guidance. I keep waiting for the reason to flee, to get out.

Not once have you judged me. Not once have you directed me. You have told me what you felt and what you thought and then asked me a question. That is a perfect fit for what I need. There is nothing wrong with me or weak about me. It’s not me that needs shoring up. It’s me and my creative process that need non-judgmental, accepting, conscious guidance and assistance. Help me see what I cannot see! Help me discern what I cannot discern! It’s so difficult for me to go in and in and in and get out what’s there and also see what’s collecting around the edges on the outside of the in.

Something like that. Anyway, it feels both imperative and organic to have you as a coach.

I am so so so grateful to you.

Back to writing!

With inspired gratitude,
Anne

P.S.

I would want to share what you wrote to me personally once and no more. I need the synergy to be between us. I just want to show an example of what the deal is. Then I want to go back in with just us. No witnesses, no critical doubters. Just us doing the thing.

Image: “Brewing a Cup of Identity” made during collage party workshop with Sarah Beth Jones, displayed in Anne’s refrigerator gallery.

One of the top triggers people with substance use disorders cite as threatening their abstinence or causing relapse is problems with relationships. Because of attachment issues, insufficient self-care and self-love, and other emotional challenges, some people suffering from addiction begin or stay in relationships that don’t help them with a fundamental of sobriety: feeling better about ourselves. Simply put, we need to leave, but don’t. Laurel Sindewald has done extensive research on the subject and synthesizes her findings for us and adds her own insights in this post. Thank you, Laurel!

– Anne

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I Control You Because I Can’t Control Me
by Laurel Sindewald

“I put a spell on you… Because you’re MINE!” Screamin’ Jay Hawkins belts chillingly out from my speakers.

He is not the first to think of love as possession or as a permission slip to control another person. What makes me feel the need to control you, my love? It certainly isn’t something you’ve done, though I may have told you so when I was angry or scared.

“People who can’t control themselves control the people around them. When you rely on someone for a positive reflected sense of self, you invariably try to control him or her.” says Dr. David Schnarch in his book Intimacy & Desire. Dr. Schnarch is a licensed clinical psychologist and author of several other books. He has found that the need to control others stems from a fundamental lack of ability to regulate one’s emotions.

The “control freak” is depending on others for a sense of self-worth and for emotional stability. In the face of uncontrollable depression or anxiety, it is unsurprising that she is constantly afraid to lose those she has come to need. She seeks to shape and determine their behaviors, their opinion of her, who they can see, and even how they feel. She is terrified that if her loved ones develop autonomy that they will not choose to be with her, perhaps because she would not choose herself.

People, like me, feel the need to control other people out of just such a desire for self-preservation. What began as an evolutionarily beneficial capacity to shape and control my environment for survival has become a coping mechanism for managing my unmanageable emotions.

I might self-deprecate and break down in tears, begging for your help. I might lose my temper and yell at the slightest scent of another argument. I lie and manipulate you, anything I can do to keep you here to keep me stable. I might not even be aware that my actions are trapping you, but my hyper-sensitivity becomes your prison nonetheless.

. . . . .

Control may be a deep human need, but it need not extend to the lives of the people around us. Whether you have a tendency to control, be controlled, or both, it’s important to be able to recognize when caring has tipped over into disrespectful restriction. This helpful list covers some of the many ways in which controlling behaviors can manifest. Other warning signs can be found here.

Examples of exerting control over others:

• Micromanagement
• Keeping a person from seeing or talking to loved ones or friends
• Gaslighting
• Dishonesty
• Over-protective or helicopter parenting
• Physical, sexual, or emotional abuse, bullying, or taunting

People who are subject to any of these, or other abusive and controlling behaviors, may not recognize the trap they’re in. Victims of abuse may come to believe they deserve such treatment or that this is as good as it gets. They may have, in turn, lost a sense of control over themselves, and may even begin to mirror some of the same controlling behaviors in an attempt to satisfy their own needs for control. The same vulnerable people who control others for a healthy self-image may be the people at risk for becoming the victim of someone who is abusive or controlling.

. . . . .

Ultimately the spell is a dance that takes two: a controller and someone who is willing to be controlled… or simply unable to leave.

In the face of cycles and spirals of control and abuse, it can be difficult to break the spell and leave if we need to. We feel lost, we victims and perpetrators of controlling behaviors. We struggle and shift our need for control from one person to the next, from one habit to the next, from one substance to the next. We look for any way to manage the unbearable sense of helplessness and terror at our cores.

Examples of controlling self or environment:

• Disordered eating
• Complusive exercising
• Self-harm
• Substance abuse
• Compulsive arranging, tidying, or cleaning

Dr. Schnarch states that the only way for any person to have healthy relationships is to develop emotional autonomy. As he puts it,”one of the kindest things you can do for the people you love is to develop more emotional autonomy. Managing your own emotions, anxieties, and feelings of self-worth gives other people back their lives.”

. . . . .

This doesn’t leave us farther apart, as you might expect. If anything, emotional autonomy is the only way you and I can have enough stability together to develop healthy interdependence. “We might fall in love but we don’t fall towards each other – we choose to stand tall by each other,” Anne told me once.

Emotion regulation is the practice of moderating and modulating our emotions so that they don’t come to control our actions (or others!). Healthy emotion regulation techniques are ways of recognizing overpowering emotions and modulating them according to how we wish to live and behave. They all begin with higher awareness of emotions as they come.

Control freaks control others partly because they are unable to tolerate negative emotions such as shame, fear, or rejection. In order to change the controlling behaviors that follow from this they must learn to cope with or moderate these negative emotions.

I need to accept even that my worst fears might come true. My controlling behaviors may have destroyed whatever precious excitement, love, and attraction might have existed in our relationship. We both may need space to heal before we can pick up relationship our again. You may need to leave to find yourself again.

If I can become emotionally autonomous, I can learn to trust myself. There is no need to fear my loved one’s actions or even mistakes as long as I trust that I can manage my own self and my own emotions. My need to control vanishes. I can leave if I want to.

The spell that keeps us dancing, focused minutely on the other person’s slightest changes of mood, focused ever intently on whatever he wants us to be doing, is broken as soon as we turn our focus back inward.

Take a deep breath, dear self. You’re wounded and that’s okay. We need some time and space to heal, but this isn’t the last time we’ll find love.

Post and image by Laurel Sindewald