Being of service

I haven’t posted any new material for well over a year. Apologies. My goal is to create at least two blog posts per month and strive towards two new podcasts per month. I’ve suffered from horrible writer’s block, and until today I couldn’t move past my current ‘block’

If you’ve followed me on Twitter for any length of time you know that 1) my grandparents survived Auschwitz, 2) my grandmother was my first sponsor, 3) I revere my grandparents and 4) I strive to embrace their model of recovery which includes me being both useful and kind.

I have been sober for over 35 years and have worked as a mental health and addictions counselor for over 31 years. While I have not provided direct clinical services for over a year, I have worked as a consultant with various orgs in the Seattle area the last 18 months. To earn a living and pay my bills I drive limo. I’ve been driving limo on and off for the last 30 years.

Driving limo has provided me with ample opportunity to be of service to others. I’d like to tell you about one interaction which has affected in a huge way and created an immense sense of gratitude for my passenger.

Over a year ago I picked up a woman from a local cancer center. ‘Denise’ was a lovely woman with porcelain skin, a slight build, and red hair. I’d guess she was about 55 years old. Initially I didn’t think she was a patient, rather, an executive working for the organization as her fare was paid through a company account. Seven weeks after our initial meeting, I met her again and understood she was undergoing her fourth round of Chemo. During the ride home she let me know that she had been sober for four months and was certain this was to be her last attempt at saving her life. My sense is that many times treatment for cancer often extends the quantity and not the quality of life. My thoughts about cancer seemed to comfort Denise and she came to understand that I understood her point-of-view.

I didn’t see Denise for a few months and was pleased when the call sheet for the day included transporting her from the center to her home, over two hours away. I wanted to catch up and ask her if there was anything I could do for her. I am seldom surprised by my limo clients but her request was a bit jarring. Denise let me know that she had been given a “timeline” by her doctor who suggested that she had less than five months to live. Denise asked me if I would be willing to capture her life and chronicle significant events so as to create a legacy for her family and friends. We agreed to meet in three weeks.

I met her at Denny’s on a Tuesday afternoon. I spent six hours asking her over 125 questions and gently prodding for more information when I needed clarification. When we departed I was emotionally spent and very sad that this lovely human being would succumb to what her doctors termed as ‘mangled DNA”. I let her know I would type up my notes within two weeks.

I called her as promised and we met at a copy shop. I was able to generate 18 pages of prepared copy from my notes and responses to the questions and recorded interview. Denise showed me 54 addressed and stamped manilla envelopes, addressed to family and friends. We made the copies and placed the parcels in the mail.

She cried as she she hugged me goodbye.

I haven’t see Denise since the encounter at the copy shop. I often wondered what happened to her. This afternoon I received a letter she typed that was sent to me by her daughter:

Dear Todd,

In the event of my passing I asked my daughter to send this letter to your supervisor. I wanted to thank you for your time and your willingness and your sincerity. I understood that you were a decent man when I met you and you were far more concerned with my comfort than you were with your work timetable. Thank you for stopping at Subway to buy me lunch. I hope you weren’t disappointed that I didn’t eat the whole thing- chemo you know.

I’m sorry we won’t get to be friends. I’m sorry I won’t get to learn more about your grandmother. I’m sorry that I left a friend. I’m sorry that I left my family and friends. Cancer sucks balls. FUCK YOU CANCER!

I didn’t realize that when I met you you would have 12th stepped me, but you shared your ESH (experience, strength and hope). I’m not sure you knew you helped me stay sober. But you did.

Thanks for your patience and willingness to spend so much time to ask me all of those questions. Thank you for spending your time to type up my responses in a cogent form. Thank you for helping me send on my ‘living legacy’ to my family and friends.

During one of our initial meetings you told me that you aspired to be useful and kind, something your grandmother laid at your feet when you got sober. I can assure you that without question, your grandmother would be proud of how you have handled yourself. There’s no reason to worry so much: you have been both useful and kind.

I will miss you


I attend meetings on a regular basis and would often lament that I seldom get to affect change driving limo. What I have come to understand is that how I affect change looks different than what a regular 12-step call might look like, or volunteering, or working with people in the program or acting as a sponsor. My grandmother used to say that when you want to develop a certain quality, you don’t get to decide how the lesson manifests.

Yep, useful and kind….

Performance Addiction: Our Secret Obsession: Guest Post by: Arthur P. Ciaramicoli, Ed.D., Ph.D

I remember the first evening I met with 44-year-old Mary in consultation. She entered the waiting room with hesitation and an obvious degree of discomfort. A few minutes into the interview she told me she could not get over her husband leaving her for a young colleague four years ago.

I don’t love him anymore, I just feel so inferior. He is a CEO of a successful company, graduated from an Ivy League school, always attracts women. He is charming, bright and handsome.

As we talked further she told me her husband had frequent affairs, always increasing her feelings of inadequacy. She practically raised their three children alone yet said little about her role as a mother. She went to college to become a teacher, and emphasized it was “just a state school.” She has tried to date since her divorce but insightfully indicated she thought her lack of confidence drove men away. When I asked what gave her such feelings, she talked about her short height, her mediocre education and her meager financial stature.

Fact vs. Fiction

Early in life we write a story about ourselves, a novel if you will. It is most often a fictitious story that is being reflected back to us from those close to us – as if we were looking at ourselves in a mirror. We are evolving and learning along the way – who we are, or more importantly, who others think we are. If the mirrors you are looking into give you an inaccurate view of yourself you begin to form a fictitious idea of your capabilities and worth.

Mary grew up with an alcoholic father who spent little time with his two daughters, but nevertheless had very high expectations on how they should perform in school and athletics. Mary’s mother had a kind heart but was quite overweight. She was often on the diet of the month, frequently calling herself fat – an idea that was reinforced by her perfectionistic husband. As a result of this environment Mary developed a critical self-voice, which supported a deep belief that she was not good enough.

Performance Addiction (PA): the belief that perfecting appearance and achieving status will secure love and respect.

This common syndrome sets the stage for what I call Performance Addiction (PA): the belief that perfecting appearance and achieving status will secure love and respect. It is an irrational belief system learned from early familial experiences and reinforced by our material and appearance driven society. I recognized this disorder as I worked with people like Mary who are intelligent, compassionate, caring and attractive, yet their internal story tells them they are inferior, unattractive and unimpressive. These individuals are what I call scoreboard watchers. They are constantly evaluating how well they sound, look and appear. They idealize others, as Mary did with her husband because of his good looks and financial success, totally missing the fact that his character is quite poor and unimpressive.

They are trying desperately to look better and achieve more to have a taste of the love and respect they have longed for since early childhood.

People who suffer from PA tend to value status over character and achievement over relationships. They are often seen as preoccupied people who are always on the move, in their minds or in reality. They are trying desperately to look better and achieve more to have a taste of the love and respect they have longed for since early childhood. Our society rewards attractive people and those who perform on high levels. Once a person has bought into the unending quest of Performance Addiction they can’t relax, let go, and let life take its mysterious course. When their efforts fail, they decide to try harder, move faster, and are willing to make more sacrifices while compromising their health. This behavior pattern is the nature of an addiction.

Mary is an attractive, bright, affable woman who has needed to uncover her true worth by being open to the fact that she has been misguided in her pursuits for love and acceptance. Rather than constantly trying to correct what is wrong with her she needed to uncover what has been right about her all along. Her natural goodness had been under cover as a result of the lack of empathy she endured early in life and later in her marriage.

Changing Your Story

In order for Mary to change her story she joined one of my group therapy sessions where members are committed to providing truthful, tactful feedback with the goal of everyone changing their story from fiction to non-fiction. You cannot change your story alone; human beings are all too subjective to do so. When we have the courage to let ourselves be known by rational people who have the capacity to provide us with a realistic appraisal we begin to see the truth about others and ourselves. It is very hard to deny feedback that comes from 10 group members who have known you for some time and all agree on a certain perception of your personality.

Over a period of months Mary has been able to understand the distortions she formed of herself. Growing up in an alcoholic home with a mother who suffered from an eating disorder left her feeling alone. Without the empathy of her parents she feel into an obsession with appearance and performance. She discovered the one way to consistently garner their attention. As a result she couldn’t resist the appeal of her husband’s resume. Her familiarity with excessive alcohol consumption made her minimize the impact of her husband’s drinking, and of his demeaning way of relating to her.

Children of alcoholics often find it difficult to understand why they would choose the very type of person that has caused them such misery.

It is human nature to return to the scene of the crime; we have a degree of familiarity with what we have experienced. Our minds tell us to run away from certain individuals. Nevertheless our hearts drive us forward to see if we can re-write the story by finally gaining the love and respect from those who are incapable of giving it, recreating our familial dynamic.

Today, after several months of individual and group therapy, Mary realizes that net worth does not equal self worth and perfecting appearance does not bring love and respect but in fact creates addictive behavior.

Changing a distorted story and the negative self-voice it creates in the most impressionable times in life is very difficult but certainly possible. Always remember that anything learned can be un-learned with patience and perseverance. I have seen many miraculous transformations occur with the support of empathic, open-minded people who are committed to helping each other reach the common goal of true happiness and health.


Arthur P. Ciaramicoli, Ed.D., Ph.D., is a licensed clinical psychologist who has been treating clients for more than 35 years. He is a member of the American Psychological Association and the Massachusetts Psychological Association. Currently in private practice, Dr. Ciaramicoli has been on the faculty of Harvard Medical School for several years, lecturer for the American Cancer Society, Chief Psychologist at Metrowest Medical Center, and Director of the Metrowest Counseling Center and of the Alternative Medicine division of Metrowest Wellness Center in Framingham, Massachusetts.

Dr. Ciaramicoli is currently in full time private practice and is the Chief Medical Officer for He has produced an Anti-Anxiety App with Soundmindz that has been downloaded by over 25,000 users and rated by Frontline as one of the most effective and usable anxiety apps available. He has also recently released an Anti-Depression and Mental Health app for Soundmindz.

Dr. Ciaramicoli is the author of The Curse of the Capable: The Hidden Challenges to a Balanced, Healthy, High Achieving Life, Performance Addiction: The Dangerous New Syndrome and How to Stop It from Ruining Your Life and The Power of Empathy: A Practical Guide to Creating Intimacy, Self-Understanding, and Lasting Love, which is now published in 7 languages, and just released in China. His first book, Treatment of Abuse and Addiction, A Holistic Approach was selected as Book of the Month by The Psychotherapy Book News. He is also the coauthor of Beyond the Influence: Understanding and Defeating Alcoholism.

Engaging Compassion in Addiction Recovery

It’s been suggested that you can improve the quality of your life by cultivating compassion. Compassion has been described as 1) a feeling of deep sympathy for another person, 2) to suffer together, or 3) concern for the misfortune of others.

Not only is compassion praised as a desired human quality, studies suggest that engaging compassion can increase the hormone DHEA and reduce cortisol, the hormone responsible for managing stress. It’s also been suggested that people who live with a high degree of compassion tend to be happier and be actively engaged in service and volunteer work.

When people live a compassionate life they tend to be admired by friends and family. This sense of compassion tends to spill over into their relationships.

I’d like to suggest five ways to engage compassion:

>Follow-through with service work. Volunteering is helpful as you are engaged in an activity that’s not about you. Oftentimes when we have a desire to use or drink we’re focused on us, our situation, or a problem that has to do with us. Volunteering creates emotional space to give you a chance to make better decisions.

>Random acts of kindness. Doing something for someone without any expectation of something in return.

>One of the most powerful tools for developing compassion is loving kindness meditation. This involves the practice of deliberately engaging kindness by focusing on internal images of different people and directing compassion towards those individuals. This also involves sending loving thoughts to people you care about.

>Develop a ritual which includes meditation time in the morning or before you retire for the night. Focus on statements that allow you to engage ways that allow you to engage loving kindness towards others.

>Practice Commonalities. One favorite exercise comes from a great article from Ode Magazine — it’s a five-step exercise to try when you meet friends and strangers. Do it discreetly and try to do all the steps with the same person. With your attention geared to the other person, tell yourself:
Step 1: “Just like me, this person is seeking happiness in his/her life.”
Step 2: “Just like me, this person is trying to avoid suffering in his/her life.”
Step 3: “Just like me, this person has known sadness, loneliness and despair.”
Step 4: “Just like me, this person is seeking to fulfill his/her needs.”
Step 5: “Just like me, this person is learning about life.”

Good luck on your path.

Increasing Self-Esteem in Recovery

If I spend time thinking about the various issues specific to addicted clients I come up with a few central themes. Many people need to find a sense of purpose, some need to find a sober place to live, and others need to find a way to earn income or repair family relationships. However, what is needed to follow-through on any of these tasks is a sense of self-esteem, or what I like to call ‘Emotional Competence’ or EC. I think of of EC in this way: are you up to the task at hand? Do you have the ability and wherewithal to follow-through? It seems to me that if you don’t like who you are and you can’t take ownership of the successes in your life then it’s very likely you’ll never like who you are. I am convinced that there is a direct relationship between poor self-esteem and giving away all of the credit in your life to a higher power.

While there are many causes of poor self-esteem, I am not convinced it is necessary that you need to know why you dislike yourself. All of the reasons we dislike who we are tend to manifest in the same way and the end result is the same: poor self-esteem, diminished self-confidence, and a poor self-concept. Rather than focus on changing the past (which is generally impossible) let’s use this time to focus on how we can feel better about our place in the world. I want to posit seven ideas for change. It’s important to try and change how you feel about yourself as poor self-esteem can lead to relapse.

1) Sentence completions: on a piece of paper start with a sentence that says “I like myself because” and complete the sentence as many times as you are able. If you feel blocked you can try “I could like myself if…..” and complete several sentences. Note any patterns and share what you learned with a trusted friend or mentor and ask for feedback.

2) Affirmations: I could spend hours writing about affirmations so I will simply encourage you to look online for ways to create affirmations. When you complete affirmations just remember: they need to be said in the present, they need to be realistic, and they need to include a level of risk. When I say ‘level of risk’ I am simply suggesting that you can read them aloud, read them to yourself in a mirror, write them on a piece of paper, read them into a tape recorder and play them back, or you can go for the highest level of risk and read them to another person.

3) Forgiveness: I suspect we all have done things which are less than flattering to our ego. It will be likely that many times the stupid thing you have done will simply work itself out and people will see that you made a mistake and will be able to let go of their annoyance about you and your actions, so take heart in that. Other times the act perpetrated against us is so great that forgiveness seems like too huge a leap – perhaps we can begin by remembering that forgiveness is about forgiving the person and not the act. Seek more support if this is a block to you.

4) Volunteer work: My grandmother would tell you that if you want to raise your self-esteem you need to do esteemable things. I am a GIANT fan of volunteer work and have done all kinds of volunteer and service work in my life. When you have a “dark night of the spirit” and you feel bad and you have done volunteer work, no one can take away how you have helped another human being lessen their burden or suffering. Your behavior is in black and white. Never forget that. Two of my favorite websites include: Serviceleader and Volunteermatch.

5) Meditation: My idea of meditation is to simply focus on one thing at a time. I like the idea of sitting on the bed in the morning when we get up and before we retire. Focus on something that makes you feel joy and breathe in through your nose and out your mouth – try this for at least two minutes each session and I suspect the long-term benefit of this practice will surprise you. If this doesn’t resonate with you, I want to invite you to explore the online resources available to you.

6) Therapy: Having a trained listening ear is important for accountability and support. We tend to experience distress when our perceptions don’t match reality. It is important to have someone provide feedback that can tell you where you might be stuck. I have been very fortunate to have worked with some very excellent clinicians in my time and these people have been invaluable to me.

7) Start something new or do something you love. If you like working with older adults, chances are that the people you work with also love that you’re willing to step up and volunteer your time. Perhaps you like walking someone’s dog or you are jazzed about writing to homebound seniors. Have a desire to connect with folks? You could begin a blog or a get involved in a letter writing campaign. My sense is that when I push myself past my comfort zones the rewards are huge.

While it can be likely that you can manage living your life entrenched in self-hate, it’s not fun and your life will feel really small. Do something good for yourself and work on yourself esteem – your recovery will thank you and the people in your life will notice that you have changed.

Whatever you decide to do, I want to invite you to begin today. Good luck on your path.

Approaching Change in Recovery

Over five weeks ago I was approached by one of my patients on the unit who let me know that he hated his life. He talked about the various experiences he had and he was concerned that a short stay in rehab wouldn’t offer him the opportunity to find any kind of comfort or relief. I suggested that rather than thinking about changing everything we could begin to think about small changes and that I would help him to begin to institute those changes. He was quite skeptical and as I expected he began to argue that my approach wouldn’t work – he engaged in what my grandmother called ‘arguing your limitations’. I certainly understand as I was aware that he was scared and when you’re scared your world feels really small. It makes sense to me that he was resistant: fear is all he knows and I am asking him to trust me (he doesn’t know me that well), and that I wanted him to try a different approach – while he is scared and his way doesn’t provide the kind of comfort he wants, he knows his way rather well and to some degree he feels safe. I was asking him to give up his way and try a different approach.

When I am working with family members or a patient I don’t see them as cynical, resistant, or pessimistic, I see their “stuff” as fear. Seeing their responses as fear helps me to relate, it humanizes them versus attaching a pathology to their responses, and allows me to tailor my approach to their response. When my patient was upset and I saw his ‘stuff’ as fear I could work with that and not personalize his unkind responses towards me. As I began to think about him I had a few ideas he could begin to implement:

1) I suggested that he follow-through with an appointment with one of our psych med providers on staff. It was apparent that while he had a history of addiction, his psychiatric history was impinging on his ability to navigate the day-to-day functions of the rehab schedule. I was able to arrange a time where he could meet with a psychiatrist who specialized in addiction and a history of co-morbid disorders including anxiety and depression. Three days after he began taking medication he started to feel better, he started to sleep 6-7 hours a night, and his thought process was better in that he no longer had intrusive thoughts and he didn’t feel distress. It’s not that I am a magician, rather, I know that medications can serve a purpose and the team was able to support him to find a combination of medications that worked for him.

2) He didn’t have a place to live after discharge as he burned his bridges with his family and after discharge without housing he would be homeless. I spent time considering the options for him and realized that clean and sober housing in addition to a case-manager to follow him would be the best bet over independent living. I talked with his mother and step mom and they were willing to support him financially for a period of time.

3) He had limited vocational skills that could offer him a way to support himself. In the state where I live addiction is considered a disability. There are various agencies that were able to take into consideration his health history, his mental health diagnosis, as well as his history of addiction. While he has yet to follow-through, he has the ability to pick from seven different careers that will offer him a living wage. Supporting someone with the best addiction treatment available is useless if a client doesn’t have a place to live or the ability to support themselves. The programs I located would give him an opportunity to work while offering him the ability to develop pro-social activities.

As I started to work to develop a safety net for this client and he began to see all of the paperwork he had to sign with the various appointments he had to attend he began to understand that I was on his side. His resistance diminished and he apologized for his earlier statements. I didn’t expect nor need an apology, however, his apology let me know that he began to trust that we were on his side.

4) I made several calls to various mental health providers with him present and he began to interview various people that provided mental health counseling. I suspected that he would do best with day treatment, however he surprised the team and decided that he would rather pick an individual provider and take the bus to various mental health groups and support linkages available to him. He took the initiative to develop a schedule and showed me how he was going to attend each group and what bus he needed to take to make it to his appointments on time. I was impressed with his ability to utilize the available resources and get his needs met.

5) We looked at two different volunteer sites: Service Leader and VolunteerMatch. He found four different volunteer gigs that suited him and filled out the applications and we faxed the applications to the agencies and made sure he added those dates to his calendar.

6) I knew that he needed a phone so we filled out an application for Assurance Wireless as well as a free community voicemail provider. He has a cat and he was given an application from the Humane Society as they do free pet food delivery for low-income clients. He had dental issues and we filled out an application for Donated Dental Services, an organization of volunteer dentists that provide free dental care. He needed better money management skills so we found a org that will pay his bills and send him a set amount of money every week so that he has a bit of spending money. We filled out an application for a reduced fare bus pass, and finally we made sure that his mediations were sent to him on a monthly basis.

Before he left treatment he wrote an extensive letter outlining his desire to follow-through and pointing out various things that were important to him. I am keenly aware that we spent a significant amount of time with this client and it took a herculean effort to connect with people that were even willing to take on someone with his his history. I am under no delusion that setting up all of these providers insures success, however……..I am also aware that the best counselors don’t always maintain perfect boundaries. I am sure that some people could argue that he should have probably done most of the work, but really, was he capable, especially when he was easily overwhelmed? Is it possible that he will be overwhelmed by the sheer number of appointments and that he will probably miss a provider appointment even though he has a schedule? Absolutely. What’s the alternative? It seems to me that supporting someone to find options and then teaching them that people want to help and that the world isn’t always a scary place is better than letting someone suffer. I’m okay with what we did.

Guess what? Today found me getting a letter from this client letting me know that he had been sober for 33 days…this is the first time he’s been sober for 33 days in over 20 years since his first attempt at recovery. He let me know that he started exercising and that the judge threw out two of the three legal charges. He is required to stay on probation for a year and follow-through with some kind of service work. Apparently the volunteer work he’s currently doing will count towards the court requirements.

Hmmm, yeah, I’d say this was successful.

Emergency Sobriety Card

One of the larger challenges in recovery is learning how to overcome a desire to use alcohol or drugs. In previous articles I’ve offered a host of tools to support recovery and encourage you to think about recovery in ways other than a conventional approach to sobriety. In this article I would like to offer a simple relapse prevention tool.

As a clinician with nearly 30 years of experience I’ve worked in a variety of agencies. Every agency would encourage you to develop a relapse prevention plan that attends to places in your life where you get stuck as well as high-risk situations that would encourage use. I think knowing what to do what you get stimulated is important, but I’ve never been a fan of the long-form relapse prevention plans. Having to look through 20 pages to see which intervention is best suited for a particular issue is a grind. My sense is that more isn’t better, different is the key. I would invite you to get several 4×6 cards and create your entire plan on one side of the card. Include the following:

Mission statement: one of my friend’s is a pilot for a major airline. He let me know that 95% of the time a plane is off-course and that you need to make adjustments to keep the plane on course. Much like a plane, we can get off course in our recovery. I would invite you to create a statement at the top of the card which supports you to make corrections in your life when your recovery is in trouble. This is my mission statement: my sobriety is the single most important thing in my life – if anything jeopardizes my recovery, I eliminate it. As I believe that recovery is a choice, it is important to be mindful that every decision we make can support long term-recovery or allow us to engage in maladaptive behaviors that support relapse and are less than flattering to our ego. All I need to do is to simply think of my mission statement and compare it to anything I want to do. Will this action stimulate a desire to use or further support my recovery? While I do not broadcast my sobriety, it is the single most important thing in my life.

Phone numbers: I would invite you to include 6-7 phone numbers of people you know who are supportive of your recovery, likely to help you if you feel like you’re falling down in your life, and are consistent in their own way. When I had about 12 years of sobriety I had a pretty strong desire to drink. I was fortunate in that I collected a list of 100 phone numbers. As my desire to drink came on the weekend during the time between Christmas and New Years most people were on vacation and out-of-touch. I needed to call over 95 people before I found someone I could talk to. Some people might consider a list of 100 people as extreme, but my sense is that I am absolutely committed to making sure I remain sober and I am willing to put in extreme effort to that end.

Alternatives: I invite you to list six to seven things you can do beyond drinking and using. I can always go to the judo hall, watch horrible sci fi, volunteer, support people online, read, play with my cat, go for a run, and remember the commitment I made to my grandmother when I got sober. It’s important to be mindful that we tend to drink or use to change the way we feel, and it’s imperative that we remember that relapse only offers temporary relief.

Rewards and consequences: I woud invite you to list six rewards and six consequences of engaging in chemical use. I think it is helpful to remember what will happen if you decide to drink or use, and I think it’s important to be reminded of the benefits from recovery. Staying clean and sober is one of the most difficult things you will do. Being aware of the consequences and rewards can go a long way to supporting you to abstain from chemical use.

I completed this exercise many years ago and over time I revised my card a few times. While I have memorized what I encouraged you to do, I can still find my card in my wallet, near my dashboard, in my bedroom, on the refrigerator, and as well as a card sitting in my partner’s house. I have laminated the card as I think this exercise is helpful and I didn’t want the paper to degrade.

My sense is that recovery looks different for everybody. I invite you to begin to develop a plan that supports you to remain sober, and offers a sense of ease in your recovery.

Good luck on your path.

An Alternative Path to Recovery

Sobriety is an interesting thing, especially as many people initially attempt to find recovery under the banner of religion at a 12-step meeting. If you follow me on Twitter you know that I am not a fan of the 12-step program. The focus of this post is to discuss a different way of staying sober that is outside the confines of a traditional approach and totally unrelated to any religious doctrine.

I used alcohol and drugs for a period of 10 years. After significant social and health problems I was faced with a decision after being in a coma for nearly a month due to my drug use. My experience as a clinician is that everybody who makes a decision to quit using needs to find their own motivation to quit and remain chemical-free. My motivation came from my grandmother when she said, “I was very concerned that you wouldn’t make it”. This is significant to me because both of my grandparents survived Auschwitz. They spent every day not knowing if they would be alive for the next 24 hours. My grandmother is my moral compass and I remember thinking that if she was able to find a way to stay alive for four years in horrific conditions, I could find a way to stay sober.

When I got sober my grandparents asked me to try 12-step meetings. I attended for some time but as an Atheist I disliked the reliance on god. I found that many people essentially traded religion for their chemical use. I also found that the “program” essentially reinforces helplessness and powerlessness and fosters a reliance on the program. I continue to hear about the success of the program, but my experience is that many people often confuse most successful with most popular.

I think about my recovery in the following ways:

I attach a tremendous amount of emotional pain to the idea or thought of using and a tremendous amount of pleasure to the thought of remaining chemical free. Not only do I stay sober because I made a commitment to my grandmother (pleasure) I don’t use chemicals because it creates more problems than it solves (pain).

I was able to quit as the people I knew who used alcohol and drugs had different goals than I did. I wanted more from my life than I was currently getting. I no longer saw drug use as fun, and everything I wanted in my life conflicted with using chemicals.

I didn’t want to be asleep on my life. It seems to me that running around being checked out all of the time because I was loaded or drunk meant that I was missing out on what I wanted to do. I have been able to maintain recovery because the things I want to do in my life and the relationships I have created are vastly more important than any chemicals I’ve used.

There are many paths to sobriety that do not require god or a need to attend meetings. I’d like to offer five ideas to enhance your recovery:

-If you want to build accountability in your recovery you can create an accountability contract. This is essentially a written document where you give permission for people to help you in certain ways if your recovery is in trouble. This also requires honesty on your part to outline what it looks like when your recovery is in trouble.

-I would invite you to talk to a mental health professional to get a temperature check’ on any manifestations which may be distressing to you. The National Institute of Drug Abuse suggests that at least 50% of people who get sober have a co-occurring disorder. The most prominent mental health issue is depression.

-Consider revisiting your diet and try to incorporate exercise into your life. I have been a fan of the martial arts long before I got sober. I am not sure I can separate where my recovery ends and where my practice of the martial arts begins.

-My entire life is focused on contribution. I can’t imagine not giving back in some way. I don’t think it matters what you do to volunteer as long as you do something. This ‘something’ could be animal rescue efforts, starting a blog, online volunteering, adopting a street where you take responsibility to pick up trash, or you find comfort working with older adults. Point your browser to or for a place to start.

-Get your butt to a doctor. I’ve lost count of how many people told me they never got sick when they were using nor did they ever break a bone. The reality is that chemical use masks all kinds of physical health problems, and it tends to create problems you’re likely to dismiss. Having a physical and getting regular blood work can be a great way to begin to feel better.

Whatever you begin to do to work towards your recovery, I hope you begin today.

Good luck on your path.

Using Bibliotherapy in Recovery

My sense is that there are many ways to get sober. Some people find success by attending inpatient treatment followed by weekly group counseling sessions. Some clients find that a secular approach works for them, and others simply see a therapist and use anti-craving medications. If we posit that recovery looks different for everybody it would make sense that self-study could be another way that some people find success in abstaining from alcohol and drugs and growing in their recovery.

If you’re looking for another way to grow in your sobriety I invite you to explore Bibliotherapy. I like to define Bibliotherapy as an expressive form of self-study. Methods consist of poetry, reading, writing exercises, and movie therapy. Bibliotherapy is an old concept in library science. The ancient Greeks maintained that literature was emotionally and psychologically important and hung a sign above the library door that read “Healing Place for the Soul”. The idea of Bibliotherapy dates back from the early 1930’s. The basic concept is that self-study is a healing experience and that this kind of study can resolve complex human problems. The practice was used in both general practice and medical care after the second world war because the soldiers had a lot of time on their hands and felt like reading was helpful. During treatment in psychiatric institutions clients have found that reading has been helpful for their emotional welfare. Today, the modern healthcare and psychiatric community recognize the benefit of Bibliotherapy for a wide range of problems.

As noted from Bibliotherapy is not likely to be helpful with clients who suffer from thought disorders, various kinds of psychoses, limited intellectual and reading ability, various kinds of dyslexia, or resistance to treatment. In addition, some clients may use bibliotherapy as a form self-help treatment rather than seeking professional help. Additional caution should be applied to people who run the risk of misdiagnosing their problem, misdiagnosing mental health issues, or incorrectly applying techniques.

The benefits can be significant for clients who are homebound, lack resources to seek professional help, failed at other kinds of therapy, or people who are self-motivated to try an approach that offers benefit that is complemented by self-study.

Dealing With Boredom in Recovery

Overheard at meetings and treatment rooms are stories of how clients report that there’s nothing to do now that they’re sober or how they feel like they won’t have any friends once they get sober. While I can certainly understand the concern, there are a lot of people engaged in a full life who are either sober or who don’t drink but have a life committed to health. It makes a lot of sense to me that finding something to do would be difficult as the focus of the using person has been primarily on using chemicals to affect their reality and change the way they feel. If you want to find new friends, try doing something new. It is likely you’ll find sober people who like to do what you like to do.

More than filling time with “things to do” perhaps it’s likely that other issues can manifest as boredom and that ‘boredom’ is used as the newly sober person is unfamiliar with the dearth of emotions they’re experiencing?

Perhaps you’re not feeling bored, but you’re feeling stuck? I know many people who like to write and often they’ll discuss writer’s block. There are many ways to address writer’s block but it has been my experience that the person experiencing the ‘block’ isn’t feeling inspired. While it’s a novel idea to suggest that you need to write when you’re not feeling inspired, it takes a lot of effort, especially if you have nothing to say. Look online and you’ll see a wealth of resources for writers that speak to writing prompts or story ideas. These are in place because people know that sometimes folks feel empty and have nothing to say.

Remember, if you are bored on a constant basis it is likely that you are boring to other people. What do you think of that?

I will give you a few suggestions and then list ideas for things to try:

Escape the desire to engage in the same behavior: Habits are likely a part of your life, but they don’t serve you if you’re not getting what you need. Find a way to break out of old patterns.

Ask a trusted friend for feedback. Tell someone you’re feeling stuck and ask them what they would do. When you get feedback, DO WHAT THEY SUGGEST!

As Stephen Covey has said, begin with the end in mind. Focus on what you want to change and work backwards to get the result you want. Do not forget to include your support group, even if you’re asking for feedback on completing a small goal. Everyone needs to be reminded.

Let go of old patterns. Stress generally happens because you believe you have to do something or you have power or control in a situation. Examine the nature of your patterns and find a way to change them. If you want to change how you feel and what you do, you can start by changing how you think.

Are you bored or are you feeling lazy? It is my experience that people generally do not follow-through because they have impotent goals. Are you doing what gives you juice or serves your higher purpose?

Are you doing something that you have done before? It can be helpful to try something different, take a different route to work, ask different questions, focus on a different solution

I would like to list a bunch of things I have tried since I got sober over 32 years ago. Very often after I got sober I would mention how I was bored. I think it’s not that I was bored, but that I needed to do something new. Perhaps you’ll find something in this list that might engage you? I hope that is true.

– Metal detecting

– Volunteering: with older adults, with a Hospice program, in a soup kitchen, at a food bank, at a library reading stories to kids or homebound seniors. Have you considered teaching someone how to read or perhaps you have skills that could support a non-profit to build their business. Ever thought of contacting your local animal shelter or the Humane Society to let them know you would like to exercise their dogs? Perhaps you know people well and would be helpful as an adoption counselor matching animals to prospective owners. If animals aren’t your thing, you could volunteer at the burn ward at the local children’s hospital. I volunteered the Seattle Children’s Hospital in the burn unit and came away with a different perspective and a sense of gratitude. In Seattle I volunteered for a program entitled ‘Books to Prisoners. This program finds you opening letters from people who are incarcerated and then filling the orders the best you can based on what is available on the shelves. I found that I would often take notes about what I wanted to add to my reading list when I paged through the books. Very recently I began volunteering as a Community Manager – that is, I am responsible for the social media campaigns of a large non-profit. This has been rewarding to me as I have found a way to channel a skill-set that I have developed over the last 10 years. If you’re stuck for ideas I would like to direct you to two websites: I am quite fond of and Serviceleader has a place on the site where you can search for virtual volunteer positions.

– Horseback riding

– Writing: perhaps you could keep an online journal, or break out a pad of paper to jot down your thoughts. You don’t need to write a tome of information, you can simply write for five minutes, include how you feel, note the high and low point of the day, and write what you plan to do tomorrow. My grandparents would tell you that if your life is worth living it’s worth recording. You can always write to people who are incarcerated or homebound. United Way generally maintains a list of people who are unable to leave their home. An occasional letter is always appreciated. I am also fond of writing letters to soldiers deployed in another country.

– Cooking. My grandmother was a wonderful cook. I often found that if I cooked what she cooked, what she made was vastly better. Perhaps love was the missing ingredient? My grandmother cooked as that is the way she took care of other people. She also cooked as it was self-care for her. You could always volunteer to cook for a senior center, nursing home, or homeless shelter.

– Completing small repairs for older adults. One of my best friends can fix anything. I recall a group of people gathering around a broken riding lawnmower offering their opinion of what was wrong. My friend patiently listened to everyone, but after the crowd dispersed he went to work fixing the mower. He gleans a great amount of pride from fixing items that would usually be seen as trash, and other people seem to benefit as well.

– Movie therapy. I love watching films, and I tend to be a horror fanatic. It’s likely that I have seen 80% of all horror films produced, past and present. When I don’t watch horror films I like to watch other movies which engage me. I have found that if I am stuck at a certain place in my life I can find a film that will speak to the issue where I’m stuck.
You can check out for some ideas for films that might engage you.

– Bibliotherapy. This generally refers to reading material to address you want to address in your personal growth or material that helps you resolve issues that are distressing to you. There is a treasure trove of material available that can assist you in moving forward and resolving what tends to bother you. I would invite you to do a search for ‘Bibliotherapy’ to get started.

– Therapy. I think everyone can benefit from seeing a counselor or a therapist. If you are newly sober it is likely that you have “stuff” that is unresolved. Having an objective opinion can be a great way of getting insight and objective feedback. Additionally, you could ask your therapist to help you resolve any issues that might be bringing up feelings of boredom for you.

– Owning a fish tank. We own two and I am always pleased to see the results of the work we put in to better the environment for the fish.

– Making digital music. I own a Mac and I am quite fond of Garageband. While I have yet to create anything which would be considered ‘music’ I have found enjoyment playing with the program to try and make music. I tend not to get frustrated as I focus on the experience versus the outcome.

– Perhaps you enjoy the library? I like to get lost in the library and wind up with many books when I walk through my front door. You could always ask the librarian if they have a program which would allow you to read to other kids.

– I have, in some capacity, taught ESL (English as a Second Language) for the last 30 years. There are many orgs which can help you get started. Most times you’ll need to complete an orientation. Check out for opportunities in Seattle or connect with The Literacy Council @ (206) 233-9720.

– Exercise. How about speed walking, weight training, martial arts, swimming, or rock climbing??

– Could you contribute your expertise on a blog or another online forum? How about podcasting?

I suspect this is enough for now. If you have any ideas for ways to challenge and defeat boredom, send them my way.

I wish you well..

Recovery Is For Anybody

Many years before I found my way into a group room or sat in a chair before a client, I listened to a recording of Dr. King and his “I Have a Dream” speech. Having listened to his speech I knew I wanted to help people in some way and I knew I wanted to affect change, I just didn’t know how. I had a dream of supporting clients to find a way to exit addiction. I suspect I must have found a way to reach my goal as more than 28 years later I continue to support people to find a way to to achieve sobriety. When I was wandering about trying different careers, I tried selling cars for a bit. The work didn’t engage me, but in some way I latched on to the idea of sales. In some way I sell sobriety. I am able to highlight the various features of recovery and like car maintenance, I am able to show clients what they need to do to achieve lasting recovery. Taking care of your car is a choice, much like recovery is a choice. To stay sober you need to do many little things on a regular basis that support you to abstain from chemicals or support you to make a decision to use in spite of all of the evidence to the contrary. It’s not much different than maintaining a car. If you neglect the maintenance your vehicle will cease to run. To this end I think that everybody has the ability to make a choice and find sobriety.

Over 32 years ago I made a conscious decision to quit using chemicals. I found a way that worked for me with the help of my grandparents. The way they supported me to remain sober looks very similar to the way I have been able to help clients find sobriety. Throughout my career I have seen various trends in the field of addiction recovery. While the addiction treatment industry was borne out of the self-help movement, things have changed. While I can see the benefit of attending support groups, most research has not affected the way support groups and the 12-step movement operate. However, great strides in modern science have brought many changes in the way addiction treatment and mental health services are delivered. We have seen the the advent of anti-craving medications, the creation of various cognitive behavioral therapies, motivational interviewing, the creation of the Transtheoretical Model (stages-of-change) short-term therapy, goal-based treatment, and the implementation of peer-led support.

While I think many changes in the addiction treatment industry have been helpful, I have seen an intensification in the negative attitudes from some folks in various support groups or clinicians in the recovery community suggesting the “new methods” are essentially harmful. I don’t think this is the case. I think that many people who see the “new therapies” as harmful are misinformed and narrowly focused. It seems to me that at times people forget that recovery looks different for everybody. I am not sure how attending 12-step meetings gives a person special insight over someone who found recovery though a therapist and anti-craving medications. It seems to me that recovery is a choice. How we get there shouldn’t matter – what matters is that we find a way and that we get there.

This might be a contentious statement for some folks, but my sense is that recovery alone is not a job qualification. I don’t think that being sober gives us any special insight into the addicted mind or the behavior of an addict. In some ways we could suggest that a period of recovery without a professional and educational background to complement our experience could be seen as a hindrance and allow us to be less than objective? Perhaps recovery alone positions us to be too close to the issue at hand and would serve as a deterrent for a sober person trying to run a group in a treatment facility. I don’t think that being sober makes us special, just different.

Many times I will hear someone in recovery suggest that ‘only an addict or alcoholic can understand another addict or alcoholic’. I don’t think this is the case and is essentially an urban myth. When I think of addiction I think of people feeling helpless, powerless, and being held captive by their dark side. My sense is that we don’t need to be brilliant to understand the mind of an addict, just human.

In my career I have worked in agencies that served clients with both mental health and chemical dependency issues. Many of the clinicians on both sides didn’t want to work together nor did they want to share techniques. I didn’t have the language at the time to verbalize how I felt, but I got the impression that some of the clinicians thought they were sharing secrets. I think they forgot that we’re on the same team.

While recovery looks different for everybody, we should also remember that sobriety is a skill. I think that as people that have experienced sobriety our job and mission is to make sobriety as accessible as possible for people who want it or express an interest.