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Eating Disorders in Recovery & our response to them

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National Eating Disorder Awareness Week (Feb. 24-March 2, 2013)

In 1990, I saw the profoundly disturbing movie Eating by Henry Jaglom. Prior to this, I was oblivious to eating disorders. The film was about a group of women cooking for a celebration. Throughout the film, they individually act out in their respective eating disorders. Watching their secrecy, shame, self-loathing, and powerlessness triggered an overwhelming sense memory in me. What they were feeling was no different than how I felt shooting coke in a locked bathroom. It made me realize how similar eating disorders were to addiction. Seeing this film helped me to feel empathy and compassion for my women friends who continued to struggle with bulimia even after years in recovery.

Our society isn’t very compassionate toward people who have diseases that manifest in self-destruction.  “How can I feel sorry for him? No one is putting a gun to his head forcing him to take heroin.”  While society is finally becoming educated in substance abuse and depression, eating disorders make people uncomfortable. It is cruel when adjectives such as lazy, greedy, and glutinous are used to describe over-eaters and those suffering from obesity. It is just as cruel to pretend there isn’t a disease affecting the health of a friend. People in 12-Step meetings become uncomfortable, even angry, if a member shares about vomiting after meals even if they share that this behavior makes them want to get high. The  whispering and dissing of the “skinny girl” is harmful and hateful. Eating disorders do not arise out of thin air. Childhood pain, violence, trauma, abuse, and sexual abuse are often at the core.

Recovering addicts and alcoholics with eating disorders are fortunate to already have a language to describe their experience. They have recovery tools and support. They know how to walk into a fellowship for their specific eating disorder and ask for help.  Yet, even with this leg-up, the road to ED recovery is riddled with potholes. I know many women with decades clean and sober whose recovery from bulimia continues to be two steps forward one step back. Binge eating relapses keep them trapped in a cycle of shame, self-berating, hopelessness, and despair even while they are role models of recovery in their primary 12-Step group.

Sustainable recovery from eating disorders is very difficult and painful and we (society as a whole and those of us fortunate to be in recovery ourselves) should be extending kindness, support, and compassion to anyone who is suffering so that they do not have to isolate in secrecy and shame. We can help by encouraging them to be honest and courageous, and by guiding them to professionals who can give them the help they need. Our generosity and love does not have to be insular. We have enough that it can be shared beyond the confines of our particular substance abuse group.

A dear friend in recovery became anorexic this past year. At first, I tried helping by applying what works to cut through the denial and arrest the disease of addiction but this was different. I realized she needed professional help and we found a therapist willing to work within her budget. After several months, it was clear that she needed a higher level of care – inpatient. Unfortunately, unlike drug addiction, there is very little help available in America for anorexics without financial resources. Anorexia Nervosa is a disease that leads to death – if not from starvation, it can cause a heart attack, fainting behind the wheel, shattered bones, and major organs shutting down. Many anorexics commit suicide before their bodies fail. Yet even with the high suicide rate statistics, there is very little help offered to people without $30,000 to spare or comprehensive health insurance. In my friend’s case though, it’s going to take more than good insurance or extra cash in the bank. Even after being discharged from therapy and told she needs a higher level of care, the denial continues to convince my friend that this disease can be self-managed.

No one could force me to get clean and I can’t force her into inpatient treatment. I hope she becomes willing. I continue to encourage her to not give up, to pray to whatever she believes in or doesn’t believe in, to blindly ask the universe or her own heart to guide her to safety so she can live. She asked me to dedicate this week’s blog in honor of Eating Disorder Awareness Week.

You may have friends in recovery living in shame, guilt and secrecy, suffering from an eating disorder they have not made public. These friends are your opportunity to practice empathy, compassion, tolerance and patience. Help them to feel safe enough to bring their ED out of the darkness. Eating disorders are not gender specific. Men this is your opportunity to bring your ED out of the closet so other men will not feel so alone. Together, in loving kindness, we can all recover.

For anyone reading this blog who may be suffering from an eating disorder, there is plenty of information online for local helplines, resources, 12 step groups. Not everyone needs to go to a treatment facility. Most eating disorders can be arrested and a healthy recovery can occur using a combination of 12 step meetings, therapy, trauma work (such as EMDR or gestalt therapy), and Dialectic Behavioral Therapy (DBT) groups, mindfulness (such as meditation, yoga, breathing exercises). Your life is worth it.

The following is a guest blog written by my friend who has Anorexia Nervosa. I asked her to write about her inner experience living with this disease. Perhaps next year she will be able to share her recovery from this illness.

Anorexia? WTF Happened?

During the course of this vicious anorexia cycle, I have confided consistently with one person. This alone may have saved my life— so far.

I don’t exactly remember when the idea had surfaced that I had an eating disorder.  At some point in late 2011 something started happening internally that resulted in an increase of anxiety, not sleeping, not eating, horrible leg cramps, night terrors, depression, anger, and hopelessness.  By April 2012 I had been in therapy for five months and remember feeling completely disconnected from my body. My mind was constantly spinning and I had 3 years clean from drugs and alcohol. I wanted to escape the screaming in my head and the pressure I constantly felt. Using and suicide bounced in and out of my mind.

I had slowly stopped eating. Well- I wouldn’t eat a couple days, but then would eat a few days and be fine. I didn’t really obsess over it and it was just one of those habits I think I had always had- since childhood. The idea of eating never really mattered to me much and the thoughts of over eating (or watching others over eat) grossly disgusted me. My frame is naturally small and the most weight I had ever gained was through both my pregnancies which I absolutely hated. Even though I had lost all the weight I had gained through my practically back to back pregnancies, my body was left with deep stretch marks which leave me with a strange self-conscience feeling I still have to this day.

Eventually, my first therapist kicked me out after about 10 minutes of what ended up being our last session. She looked at my sick body and advised me to come back after I sought help for my eating disorder. I hadn’t really talked much to this therapist but felt extreme anxiety when I knew I had an appointment that day and felt like I had been hit by a bus when I left. I don’t remember talking to her too much about anorexia.

Over the last year, I’m not sure why I have constantly denied that I could have an eating disorder. Most of the last year and a half has consisted of not eating, weighing myself obsessively, checking my BMI to see if I’m actually underweight (thinking that as my BMI is normal than I must not have a problem), puking every 3-4 days when I do actually eat, migraines, performing google searches about eating disorders, crying, punching walls, throwing chairs, anger, hiding out…

My health has been questionable. My digestive system feels fucked up. My heart rate and cholesterol are high. I’m almost positive I am anemic. I’ve passed out, lost track of time, been in four car accidents, fallen asleep at the wheel.  I have severe leg cramps every night which leave me falling down. I lost 30 lbs on my already somewhat small frame in the course of 4-5 month period and my weight was declining weekly. People were commenting on my body and it infuriated me when they questioned if I ate or if they told me that I’m getting too thin. I read articles and books about how to get help. I went to eating disorder meetings. I wrote letters to the fucking universe expressing my anger and pain and needing help.

Yet with all of the evidence pointing toward the clear fact that I do have an eating disorder problem, I continued to fight it (I still fight it).

I want help and I don’t want help. I want to fix my own problems and my own pain. I don’t want to let one more person close to me. I don’t want to become vulnerable.

I did eventually go to another therapist who specializes in eating disorders. I made as much of an effort as possible to kick this shit and feel better. I deactivated my gym membership, I gave up my scale, I wrote food logs. The terms were up front from the beginning with her. I had to stay honest. I had to do the work. If after a certain amount of time, no progress was made with my health, than she would recommend a higher level of treatment. This was and is one of my greatest fears. Needless to say, I was discharged in January of this year from my second therapist.

I actually made it to 4 years clean in January but feel like I am living my life in active addiction. I feel like I am in a downward spiral but not sure exactly what I am willing to do to get better. I still fantasize about all of this just disappearing on its own.  I feel like my mind is playing tricks on me. I tell myself things like this: I haven’t thrown up in a while now, I ate twice every day for 5 days in a row (only skipping two days of meals), I haven’t weighed myself since being at Publix two weeks ago, I am sleeping more than I had been sleeping, and that I haven’t lost any weight since my last therapy session. All of these things I tell myself eventually convince me that I can fix this by myself because I am obviously doing better than I was when this ‘eating disorder’ surfaced.

I absolutely hate everything about anorexia. I hate what is happening and feel trapped. I hate feeling like  there is something wrong with me and that I can’t control any of this. These are the same thoughts I have about addiction. I despise them both. I hate the internal fight of wanting to die and live all at once. And I hate feeling like I am being attacked by one or the other, if not both

Fuck addiction. Fuck anorexia.

Truth is- with all of my denial, anxiety, rage, depression, etc. -   I do hope that I continue to hold on until I get better.

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Is there a faster way to learn patience?

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Vigilance – the process of paying close and continuous attention; wakefulness, watchfulness

“Vigilance is especially susceptible to fatigue”

Staying in the recovery process requires vigilance. If change takes time and fatigue is the enemy of vigilance –what’s an addict to do? The answer is simple: we need to learn patience.

We want what we want when we want it and our society caters to this fact. The 60’s invented fast food drive-thru restaurants and instant add-water meals. God knows no one has time to wait for anything. If we don’t see results immediately, we lose interest in going to the gym. We can now get liposuction if we don’t have patience to diet. Who has the time to wash and cut vegetables, never mind prepare an entire meal? If we have to wait for anything our first thought is “What’s the point?” and then we lose interest – whether it’s in learning a new skill, preparing a healthy meal, or sitting to meditate. If we can’t be at yoga within minutes of leaving the house, forget it. And I’m not even factoring being a recovering addict into this rant. Everyone is born hungry.

While lacking patience can have consequences for anyone, for addicts impatience can lead to the “fuckits” – the precursor to relapse. This is why we have to keep being reminded that recovery is an ongoing process and that it requires vigilance.

In early recovery, it feels like we’re constantly being hit by an onslaught of feelings. After years of dulling or numbing ourselves with substances, the reawakening of our emotions is new to us. Fear seems to lie underneath every sensation. Even joy can be accompanied by the sensation of waiting for the other shoe to drop. Anger makes us want to use, sadness makes us want to vanish from existence. We look at other people in recovery who seem to be at peace with themselves and we want to know how they got that way. We want to be like them right away. We expect recovery to give us instant results. “I worked my steps and go to therapy but I’m still a mess. What am I doing wrong?” Instead of accepting that change occurs over time, we blame ourselves.

Sometimes we can will things to happen – or so it seems. It could just be that everything aligned and we get what we want right away. Instead of it being an isolated incident, it makes us think if we don’t get things right away, we mustn’t be doing something right. Anxiety builds and patience evaporates. Enduring time passing is not the same as being patient. Being patient is an act of faith – faith that time will pass and things will change – however they will change. Patience is not counting the days and minutes.

People always ask, “What’s the trick? What work can I do to acquire patience quickly?” (Yes I’ve really been asked this). Translated, I think they’re admitting that they understand the concept “change happens slowly over time” but want to know how can they exist inside of this unknowable timeframe without having an anxiety attack or pulling their hair out. The trick is to create mindfulness habits so they can slow themselves down – whether it’s by quieting the mind or reducing physical anxiety. This makes not only the passage of time more bearable; it will probably be more enjoyable.

There is so much information readily available on mindfulness techniques and practices. A quick search of Google or YouTube can bring up thousands of links. When I was in early recovery I couldn’t focus my attention on anything for very long before I felt like I was crawling out of my skin. The idea of meditation was nice but I drank far too much coffee to attempt it. I’d overthink everything and believed I’d need to take a class, join a group or read a book on it before I could start. If I was going to meditate, I wanted to do it right. Truthfully, it was easier to sit in a café with my friends drinking coffee than it was to set aside 20 minutes to try to quiet my mind. No one ever explained to me that if I could set aside this time, I wouldn’t feel that “crawling out of my skin” feeling as often or as intensely. Had I known what the payoff was going to be I might have tried it sooner. I was resistant because, deep down, I equated meditation with edgelessness. Now I know that is not  the case.

There are a few quick tricks anyone can do throughout the day. They are pretty low-effort but you’ll feel results immediately. You can do them at any time, anywhere.

Start by taking a few deep breaths. Get on your tiptoes and reach up over your head and stretch out all the way through your arms to your fingertips and wiggle your fingers until you feel the stretch go all the way to through your fingertips. Lift one foot off the ground and rotate your ankles and stretch out your toes. Now do the other foot. Meanwhile flex and release your leg muscles. With one hand to the sky and the other pointing to the ground lean to the left and feel the stretch move down your sides. Do the opposite side. Tilt your pelvis forward and backward then rotate your hips in a circular motion and reverse the direction. Roll your shoulders in a circular motion and reverse. Tilt your head all the way forward and all the way back, and then try to touch each ear toward your shoulder. Roll your head slowly in a clockwise circle several times then reverse. Squeeze your shoulders up toward your ears and release. Do this several times. Now bend forward and let your arms hang. Swing from left to right and slowly move up your body, both arms swinging from side to side. Raise your arms over your head and bring your hands together and lower them toward your heart. By now your body should feel relaxed and energized. You can do all of this in less than 5 minutes as often throughout the day as you can remember. In fact, why not schedule it into your phone now to do 5 times during the day until it becomes a habit.

Take a look around. Pay attention to the immediate details to your surroundings. It doesn’t matter whether you’re standing at the back of a restaurant or on the sidewalk, pay attention to the colors, the light, and the sounds. This brings you into the moment. When you are in the moment, fear doesn’t have power over you. By existing in the moment, you’ll be less distracted by your thoughts.

Another quick decompressing trick you can do is to take ten deep slow breaths. Inhale through your nose until your lungs and belly have expanded as far as they can and then blow all this air out through your mouth until you are completely empty. You should be feeling the muscles in your chest and stomach relaxing with each inhalation and exhalation. It may feel like your heart is racing but it’s really just the awareness of your heart and your body. It’s nothing to worry about.

By stretching and breathing, you’ll become conscious of your body and breath so this next trick will be quite easy to do. Whether your eyes are open or closed, feel the air moving into your nostrils. It should feel slightly cool on its way in and warmer on its way out. Control it by inhaling and exhaling slightly longer. Most likely you’ll have to yawn several times. Feel the stretch in your jaw when you do. By doing this exercise you’re going to start noticing the way the air feels entering and exiting your nostrils throughout the day. You’re building a relationship with your physical body and an awareness of the moment you are in.

You’re probably wondering what any of this has to do with patience and vigilance. By creating these habits and incorporating them into your daily routine early in recovery, you are exercising some discipline over how time is being spent. It gives you control over how you want to feel physically and emotionally. Less anxiety means less fear. And fear is what sends signals that say, “If it’s going to feel like this, why bother ?” Less fear means less pain. Vigilance is not giving up.

We are like a porcelain vase that fell off a table and shattered across the floor. A lot of damage has been done. We gather up the pieces and enter recovery hoping someone will tell us how to put it back together. And people tell us how – but they also say, “It takes time.” We start going through all the pieces and start to figure out what fits where so we can put the vase back together again. It takes time and patience but we know the pieces will eventually all fit. If we approach this task in a hurried, stressed out way, we’ll make a mess of it and end up taking longer to get it done. By practicing some mindfulness, we are able to enjoy the process and we’ll feel excited when it begins to look like a vase again. It takes vigilance and patience to put ourselves back together. Honestly, if the payoff didn’t exceed the work we put into recovery, no one would stay clean. This payoff is why we keep blindly moving forward even when we can’t see what’s ahead. Patience teaches us that the real prize is the journey.

 

 

 

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The Upside of Shame

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Regrets. I’ve had a few, but then again, too few to mention. (My Way, Frank Sinatra)

Wouldn’t you love to be able to hit rewind and delete entire episodes out of your past rather than have to deal with the fallout clean and sober?

When I used to try to kick dope, the physical withdrawal was nothing compared to the  movies playing non-stop in my head of every single thing I ever did or said that made me feel like shit. It always touched on the things that hurt or betrayed the people I loved (whether they knew it or not) like birthday money from my folks I’d blown on coke, the time my dad drove from Toronto to Buffalo to meet a flight I’d forgotten about, relationships I’d discarded, friends I’d lost, the time I left my dog in my apartment while I spent a weekend on the Virgin Islands. It was all there in living color, the shit I did, accompanied by a gnawing soul-sickness.

The behaviors we engage in that fuel the beast don’t completely disappear when we get clean. The “disease” gets a lot of mileage from shame. Whenever we act out in our selfish or thoughtless behaviors in recovery and feel bad, thoughts of using pop up – always an unconscious antidote to our negative feelings. The way out of this cycle is in repairing damage we have caused and learning how to do things differently. Recovery gives us the opportunity to change.

On a positive note, guilt and remorse are natural healthy feelings because they let us know we are not psychopaths.

It’s through these feelings that we build our moral backbone in recovery. This moral compass lets us know how far we have strayed from our own deepest beliefs and values. They teach us right from wrong, teach us how to be loving – toward ourselves and others, toward animals and nature. We don’t learn this by having debates, or philosophizing over coffee with our friends, or because family, religion or the courts shoved a moral code at us. We discover morality through our feelings. And they never lie. They let us know when we do something that betrays our very nature.

Shame is the real killer for addicts because shame is personal. It’s how we feel about ourselves in the privacy of our own mind. How are we supposed to take care of ourselves, love ourselves, if we believe we are worthless? “We are as sick as our secrets” is true because shame is so personal. Guilt says, “What you did was horrible.” Shame says, “ You are horrible.” Secrets nurture shame – so get rid of them.

Imagine – even at the peak of our addiction we could not escape regret, guilt, or shame when we acted out against our most heartfelt beliefs. That says a lot about the human spirit. Even when we believed we truly didn’t give a fuck our heart was storing up the memory to haunt us later. The human spirit is pretty amazing. Even the madness of addiction can’t reach in and completely rewire our conscience.

 

 

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“But mom, you know I can’t drink!” Holidays in Recovery

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I stopped eating meat in 1983 yet every few years my mom will say something like “It’s Thanksgiving. You can have turkey on Thanksgiving.” She isn’t opposed to my not eating meat, it’s that she can’t wrap her mind around it during holidays. I suppose the memories that make her warm, fuzzy and sentimental involve us all sharing the same meal.  I mention this because a lot of people in recovery will be going home for the holidays. Many are going to have an experience similar to mine but instead of turkey it will involve alcohol.

If you are new to recovery, you’re going to keep hearing people talking about how difficult the holidays will be and how many people will relapse. This is going to either scare the crap out of you or you’re going to dismiss it by thinking, “This doesn’t apply to me because I have absolutely no desire to drink or get high whatsoever.” The truth is – none of us can predict how we are going to feel ten minutes from now let alone during the holiday season. It’s better to enter the next few weeks prepared for anything. Have a solid recovery plan to increase your accountability to your support group, know where there are meetings ahead of time for wherever you will be traveling to, have people you can call at any hour, and make plans so you don’t spend the holidays in isolation or spend it exclusively in the company of people who are partying or who have the ability to push your buttons (family).  Basically whatever level of daily actions you now take to keep your recovery a priority, increase them until after January 1st. Better safe than sorry – and sorry does not mean relapse. It can mean emotional discomfort, living with heightened anxiety, or riding the roller-coaster of shame, remorse, or anger.

In most cases, your immediate family will be supportive of your recovery but they may not understand the disease. To them, you are doing so well they may not see any harm in a glass of wine at a toast or alcohol soaked desserts. It’s up to you to educate them beforehand on what you need. If you go to 12 Step meetings, tell them beforehand when you will be attending them so they aren’t disappointed if it conflicts with their plans. You don’t want to be in a position where you give up your meeting because your mother is upset. Also, let them know if going for a walk/run/yoga/gym is something you have to do for your mental and emotional well being so that you don’t get moody and lash out. If alcohol drenched sweets are part of the dessert ritual, make sure there is an alternative for you to enjoy. And most important – if your family’s idea of fun is getting sloshed together, know when it is time to leave. Don’t stick around for the insults on how you are now a stick in the mud or debates about whether or not you are an alcoholic.

Self-care and sobriety involves preparing for the holidays. While they are almost always a roller-coaster of the unknown to the newly clean and sober, those of us who have some time under our belt can still be hit with loneliness, grieving for those who are gone, feelings of inadequacy or whatever negative self-talk that can surface when we are the sober one at a party. Thank God, it does get easier. Holidays clean and sober really can be a blast. Even so, it is always good to have a recovery plan in place.

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National Survivors of Suicide Day

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National Survivor’s of Suicide Day November 17 2012

Today I spent time thinking about those I’ve lost to suicide and their families.

I got news this past week that another friend from my early recovery overdosed and died. This makes six friends since March. Five had been in recovery at one point for anywhere from one to twenty years before they decided that they could drink or smoke weed without getting caught up in old ways.  The news is never easy. Over the years I ‘ve been clean, there’s been a lot of death. Overdoses and suicide top the list followed closely by AIDS and Hepatitis C. I’ve spent a lot of time searching for meaning, contemplating life and death, and coming to terms with it in a way that makes sense to me personally. At one point I started to numb out. I would hear of a new death and mentally delete their number from my cell phone – gone! They were gone. Over! The end! I noticed my lack of emotional response and figured, really, how much death can one take? Nowadays, I’m back to feeling that funk land hard in my stomach and the sad sound as my head whispers “Fuck!”

My best friend committed suicide in the mid-80s. I wrote about her in an earlier blog on my other site http://www.pattypowersnyc.blogspot.com/2011/09/finding-one-day-at-time.html. That death hit me at a time when my own life was spiraling out of control. I felt I understood what she was feeling at the time -that feeling of not wanting to play anymore, of being tired, of not believing things would ever change. Little did I know that within three years I’d find recovery and my life would change radically.

I’ll confess that, for years, I held a little idea at the back of my most private thoughts: I would do this life-on-life’s-terms recovery thing as long as I could but if I ever got tired and want off the ride instead of getting high, suicide would be my way off.

At seven years clean I was hit by a depression I’d never experienced before – coming out of the blue and unattached to any plausible explanation. There was nothing going on in my life I could pin it to. I felt like I was inside a bubble preventing me from feeling a connection to anything or anyone.  I spent days laying on the sofa telling myself “This too shall pass.” The next day I’d awaken to realize nothing had changed. I had no desire to get high and wondered how long I could live this way.  When would enough be enough and I’d check out? I was also writing a novel where the main character would attempt suicide so a variety of methods were at my fingertips. Needless to say, it wasn’t a good time to spend days alone with my mind. Was this feeling ever going to pass?  The day I woke up feeling alive again was one of joy and relief. Shortly after this, a friend’s son hung himself.

While laying in my self-absorbed darkness fantasizing about suicide, it never occurred to me to consider how my death would affect others. Witnessing first hand how his suicide impacted the lives of his family and friends eradicated suicide as my exit strategy.

There was a hint that the latest death may have been intentional because of his history with depression.  Addiction and depression are closely linked. Perhaps this has played a role in all the earlier suicides. Much has been discovered and documented linking addiction and depression since my early years in recovery. Back then many recovering addicts shunned the idea of taking any sort of pill. Instead they believed in toughing it out, working a stronger program, finding a god. Many struggled with undiagnosed mental health issues for years, living in pain, until they finally sought help. It wasn’t that recovering addicts wanted to martyr themselves. Antidepressants were a new concept and many of us twelve-steppers were naïve and ill-informed.

I think a lot about my friends who’ve died, wondering how many of those overdoses were suicide.  How many kept their depression a guarded secret in recovery? How could we have helped?

That is the biggest question survivors of suicide torment themselves with – “What could I have done?” It’s heartbreaking to see and hear the grief lingering years later, wrapped around them like a blanket for the remainder of their lives. If a loved one has committed suicide please find support groups and professional counseling. The impact of suicide can be trauma.

For anyone who is considering suicide I will pass on something someone said to me during a particularly difficult time:

Patty, life is like a long phonograph and right now the needle is skipping but there is still a long beautiful song left to play. I know the pain is so big you can’t breath and it feels like it will never go away but this is really just one moment in time of a very long story and when you get past it, you will always look back and remember this period as a hard one but you won’t even be able to connect with the pain that right now feels like its going to kill you.  It will just be a memory that things were rough. While you’re in it, it feels so much more meaningful – but it’s really a just rough patch in a skipping record. Not worth killing yourself over. Because then it’s over forever.

Hang on and ask for help!

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I didn’t get clean for this sh*t! Unmanageability.

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This has been a crazy summer for me. Not “crazy” in a wild and fun way either (sorry to say) but crazy in an unmanageable “life on life’s terms” way. This is my first summer in New York City without air conditioning and the hottest recorded summer since the 1800s. They decided to re-wire my building (an old brownstone in the Village) and hired one electrician to do all the work. I struggled through one major heatwave after another, sitting inside my apartment feeling like a dog locked inside a car with the windows rolled up.  I found myself crying at my desk for no reason. I’ve discovered that severe conditions can bring on feelings of despair and depression – go figure! I had to turn down several clients because I was in no shape to help anyone and writing was impossible. Instead, I went to visit my folks in Canada for a couple weeks and expected to come back to air conditioning. Well – what do you know – Con Edison went on strike so there is no one to do the inspection. There will be no air conditioning this year. The upside is that I knew enough to leave town to rejuvenate my spirit and have since put myself on graveyard hours so that I can bike in the cooler evening breeze for fresh air, write at night, and see as many matinees as I possible. I’m making my situation as manageable as I can because my mental health matters to me. I am powerless over the circumstances but not powerless over my ability to make choices to improve my situation. I needed topics for this blog to simplify my workload so I asked for help.I got a lot of suggestions. Phil wrote me this, which I felt was appropriate to use first:

Recovering addicts are always asking as to what they can expect to “manage” in the sober future and what they cant.  -Phil

When we look back at the unmanageability of our lives during our using days the list goes something like this: jobs lost, apartment evictions, regularly living without a phone or electricity, calls from collection agencies, owing everyone we know money, significant others leaving after many tears, fights and drama. Our health deteriorates and there are trips to hospitals, jails, and psych wards. Paramedics bring us back to life and even this doesn’t strike us unusual. What’s worse than the exterior unmanageability is our inner life – we can’t handle experiencing negatives feelings yet they seem to be the only feelings we have. Our only coping mechanism was to keep using in the hope of finding some inner peace.

Clean and sober, unmanageability in our lives can look like this: jobs lost, apartment evictions, regularly living without a phone or electricity, calls from collection agencies, owing everyone we know money, significant others leaving after many tears, fights, and drama. From neglecting our health there can be   trips to hospitals. If we don’t change our behaviors we can end up in jail and there could even be times we end up in psych wards.

In recovery, even when our external life can remain manageable, our inner life can be filled with anxiety, self-loathing, pain and torment. “Why is this happening to me?” we cry as our thoughts return to the old solution – getting high.

Recovery is the process of changing our behaviors and our response to situations so that we don’t back ourselves into an emotional corner where getting high seems to be the only way out. If any addict stays in pain long enough, s/he will use.

It’s our responsibility to manage every area of our life in a way to keep chaos and drama at a minimal, We learn to start paying bills on time, communicating honestly, become willing to renegotiate or compromise in relationships, We address health and mental health issues, earn money the old fashioned way of working for a living. The hilarious thing writing this is that I know everyone reading it is thinking “Of course we have to do this. Tell me something I don’t know.” It sounds easy to live an upright, ethical, honest life clean – but is it? I mean – really?

This is what I have seen over the years: some addicts gets clean and lives a very rigid life – so rigid and fearful of making errors that the first chance they get to let their hair down, they get loaded. Then there’s the addict who continues acting out deviously in some areas all the while spewing wisdom of recovery louder than anyone else. I call this the “Spiritual giant who goes home and beats his wife and kicks the dog”-syndrome” (not gender-specific) who, without change, will also eventually gets loaded. And then there’s the middle ground – the category that most of us fall into – we hold onto old behaviors as long as they work for us before we become willing to change. And we only are motivated to change by pain.

I didn’t learn how to pay parking tickets until my car was towed, pay my phone bill on time until I got sick of losing money to reconnection fees. It’s true – there are a lot of people in the world who don’t go to the dentist until they are in excruciating pain but for addicts being in pain brings a cry for drugs. Non-addicts experience unmanageability the same as we do. The difference is that they will not respond to it by self-destructing.

It’s important to understand how the disease of addiction gains ground. It LOVES when we are angry with ourselves. No one can ever treat us as badly as we treat ourselves inside the privacy of our own mind. This is why we need the love and support of other recovering addicts. They remind us to give ourselves a break, teach us how to find working solutions to the problems of daily life, let us know that our fantastic idea on how to beat the system is insane, talk us out of that one last heist, help us recognize when the criteria for a boyfriend is different from the criteria for a sugar daddy. Recovery teaches us how to live without being motivated by the fear that if we let go of our old hustles and irresponsible behaviors, our need to get over on the system, that we won’t make it.

It’s unrealistic to expect to come into recovery and immediately live a life 100% according to new recovery principles. We do our best.  We grow in leaps and bounds in some areas and stay sick and stuck in others. The pain from unmanageability in the form of drama, chaos, and from the consequences of our actions is what teaches us who we really are –in our hearts not in our minds. We discover that don’t want to keep hurting ourselves by living this way and this gives us the strength and courage to change. This is a good thing. Because we don’t want to suffer, we learn how to do things differently.

In recovery we can be free. Not just free from the enslavement of addiction but free from senseless self-made suffering. The calm and inner peace we feel by living a life of less drama and unmanageability will eventually guide us in all our affairs. Nonetheless, shit does happen – economies crash, people die, lovers leave, personalities clash. Sometimes we may have a long string of bad luck and feel like life is not fair. We cry, “Why me?” and an old voice will whisper back, “Fuck this shit. You didn’t feel this bad when you were using. Fuck this recovery bullshit.” Yep – the disease never gives up, always waiting for a moment of weakness, always quick to point out the hopelessness of it all. During these times lean into recovering friends for support, love and guidance.  When times get dark hang on because this too shall pass. It will and it does.

Recovery is harm reduction for day to day living.

 

 

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Anatomy of a Vacation

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I don’t know about you but getting clean made my life a whole lot busier. Twenty-three years later and the need for downtime and timeout from the day-to-day grind is as essential to my well-being and recovery as it ever was.

I’m writing this blog from my parent’s house in rural Ontario Canada. Every summer I spend two weeks here, a combination of amends and vacation time. My parents left the city of Toronto six years ago and moved to a town of eleven thousand people who are spread out across thousands rolling acres of farmland and forests.  A seven-minute drive ends at a sandy beach on Lake Ontario.

Usually I spend the majority of my time here in the yard or in my room working on whatever project I brought along. This trip has been different. I’ve spent a lot of time playing ball with a twenty-month old Jack Russell named Harley. Most days I take Harley to a stone beach and throw sticks into the lake for him, go on long country bike rides, walk the dog to the horse farms, and at some point drive back to the beach for a long swim. This routine is broken up by whatever scenic drives my parents want to take. Occasionally I will go to my room and check email or my cell to see if I am missing anything from my life in New York. I’m not. Until tonight, I also haven’t been writing.

Vacations are a time-out from the daily grind of life. I don’t know about you but I tend to forget this. I hear friends talk about doing nothing on island vacations but that has never been my style. Normally a vacation means visiting a new city somewhere on the planet and exploring it from morning until bedtime. My vacations are usually heightened stimulation and inspiration and a break from my regular life. Coming to Canada and forcing myself to work everyday at my computer was as close to doing nothing as it gets for me. This year I am having a real vacation. I must under-estimate the sheer levels of stress city life imposes: the noise, the crowds, the pressures to be here and there, the effort to maintain healthy balance with recovery, exercise, leisure, work, diet – the effort to stay sane. I love city life but it is important to take time out.  It took three days for my body wind down and a new level of rest come into me. I see this vacation as a re-up.

I arrived here with a lot of noise in my head. The list of what I need to get finished, emails that need to be sent, dates I need to schedule – there seemed to be a lot of things I “needed” to do – so much that I felt overwhelmed. Two weeks in a heat wave without air conditioning and I’d done nothing. So I arrived with stress and anxiety and exhaustion. This of course felt like low-grade depression. Free-floating waves of despair swept through me. I arrived depleted. Thank God. I was too beaten to summon the fight to keep going at my usual pace. Defeat was the silver lining of that heat wave.

Two days of napping and my spirit lightened. On day three I went to the beach. From that point on, my days have been spent as I indicated above. I now notice clouds, the smell of cedar as I bike past a forest, the sound of the waves hitting the shore, sunsets on the water. I have a sense of peace that is deeper than what I am able to get in the city with yoga, meditation and visits to the park. Sometimes you just have to step away from your life to get these needs met.

In recovery, I have learned to listen to my heart (or to my gut). It always lets me know what I need. This was even true in early recovery. You may not know you are stressed or burnt out until a friend tells you but if you take some quiet time, your body will let you know what it needs. It could be an air-conditioned movie to buy 90 minutes of not thinking about your life or texting anyone. It could be a long walk in the evening, a bike ride, a dance class. Your spirit will always cry out for some relief from the grind but it is up to you to feed it.

If you can’t get a vacation, give yourself one weekend day as a day for yourself and schedule in something that will feed your spirit: nap time, a country or beach walk, a river stroll, a picnic in the park with your favorite book – and please leave your cell and your i-pad at home for a minimum of 6 hours. I’ve checked mine and 8 days later, my real life has not fallen apart.

If your life is so busy that you can’t afford a whole day for yourself, schedule in several hours a couple times a week and use it to go outside. Pay attention to the small details in your view. We all have scenery, even in cities, so take some quiet time and look at whatever beauty there is around you. Think of it as a mini re-up.

Visiting parents can be the most stressful thing people in recovery can do and during the first 7 or 8 years of my recovery I never knew what to expect. Would I revert back to asshole teenage behaviors? Would old resentments take over my thoughts? Would I arrive with expectations and be disappointed? Would I blurt out something hurtful I couldn’t take back?  Visiting family didn’t always feel like a vacation. Luckily, the ongoing process of recovery has healed a lot of old wounds, given me perspective, and has changed my relationships – even with my parents. I am enjoying a peaceful vacation without busy-ness, without having feelings I need to escape from, and in the company of two people I am grateful to still have in my life.

In recovery, we change and our relationships with others change. You may cringe at the idea of two weeks with family but if it is something you do, who knows, maybe one day you’ll discover yourself enjoying it. Summer is a glorious time. Wherever you are and whatever you do, set aside some time to enjoy it and be rejuvenated by it.

 

 

 

 

 

 

 

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How can I tell if I’m heading toward a relapse?

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Last week I had the fun experience of being a guest “speaker” on a Twitter addiction chat. I had no idea how I was supposed to be a  “speaker” in 140 characters or less. Luckily it turned out to be a Q&A. The final question  “How can a person tell if they’re starting to relapse and how can they stop themselves?” seemed like a good topic for this week’s blog post.

The interesting thing about a relapse is that afterward the addict will swear, “I made the decision to use” when really, “I made the decision a while ago and using was the anticipated outcome” is more likely the case. When we’re clean we always have a choice. By the time the “decision” to use comes along, we’ve already given up that choice by not recognizing and correcting the behaviors that were leading us toward a relapse in the first place. When we are in the disease clean, the window of opportunity to choose recovery gets smaller and smaller until our disease is stronger than our recovery and we use.  We forget we are powerless once we use. Almost every addict who has relapsed tells me immediately afterward, “If it gets bad, I’ll get clean again”. Really? If it was that easy to get clean, why wouldn’t I use one day a year?  They get amnesia about what it took for them to ever have had the desperation to get clean in the first place.

So what are these behaviors we need to watch out for and take seriously that have the power to eventually lead us back to using?

We start to come up with reasonable sounding reasons to start missing meetings (or IOP or whatever support group you are part of).

We start finding our recovery/sober friends annoying. We don’t feel like being around people and are much happier when we’re alone.

We feel a general crankiness toward everything.

We feel an endless hunger for anything (food, shopping, money, power, sex, attention, caffeine, tattoos, seductive pain) outside of ourselves to make us feel better, to feel excited, to feel alive. We long for euphoria.

We stop doing things we used to enjoy in our fellowship such as service, group activities, fellowship, stop working the steps (usually after step 5), stop talking to our sponsor/sponsees. In fact we start feeling judgmental toward both.

We start acting out in asshole behaviors without noticing such as gossip, anger, deceit, and righteousness. We nurture our resentments and start keeping secrets. Consequences include shame, remorse and guilt yet we do not talk about these feelings or their source to anyone.

We’re Hungry, Angry, Lonely, Tired.  We take no action to remedy it.

We start hanging out with people who are not in recovery more often than people who are. Watching our friends who are not addicts use and drink starts making us have thoughts that we can do it too. We tell no one this.

We hang with using addicts and alcoholics and enjoy it. We believe it is not affecting us. We make less time for friends in recovery.

We act out in self-destructive behaviors such as cutting, eating disorders, sexual       compulsion, unsafe sex, compulsive Internet cruising and tell no one.

We isolate in abusive or unhealthy romantic relationships wanting someone who         doesn’t want us yet going back time and again expecting different results.

If you are doing ANYTHING that your head says is nobody’s business (not even the person you trust most with your recovery) LOOK AT IT.

I really believe that if an addict stays in emotional pain long enough the only solution guaranteed to bring relieve will be using.

A relapse can usually be traced back to a combination of these behaviors occurring over a period of time. If you see any combination of these happening in your life, start taking the opposite action. This can be as simple as removing yourself from the situation, recommitting to meetings, service, reconnecting to your support group and being thoroughly honest about devious thoughts and actions.

 

 

 

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For the Ladies: Hormones are a Bitch!

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Let me set the stage:  I wake up feeling relatively normal. It’s true the night before I was starting to have a few alienating judgmental thoughts about one friend or another but I didn’t trip on it.  Today I’ve been busy on the computer and taking care of a few things around the house. I  make it through the first half of the day without talking to anyone. Now it’s time to head uptown. On the subway, as people begin to crowd into the train, I notice a few minor character assassinations take place in my head whenever someone stands too close to me. When I switch trains, the walkways fill up with people who have no urgency in their step. I pick up my pace and aggressively snake through the crowd. It isn’t until I descend the stairs to my connecting platform that I spot the source of the pedestrian traffic slowdown. Two people are standing at the foot of the stairs having a conversation during rush hour. I shoulder hard into them on my way down but really what I want to do is grab them and throw them onto the tracks. How can anyone be so selfish and stupid as to block a stairwell in New York City during rush hour? These two clearly deserve to die.

I tell this story because this was a regular occurrence in my life. In fact, it was a monthly occurrence. This is how the first sign of my PMS would announce itself – homicidal fantasies. Like character defects that often only appear when dealing with others, the beginning of PMS would be undetectable until I was out among the human race. This would be my yellow warning light for what was to come.  In the hours after my subway rage, I would turn the anger and disgust toward myself. I’d become both judgmental and insecure. Character defects would flare up and I’d act out on resentments with gossip followed by shame and paranoia. In the end I’d be so raw and vulnerable and filled by self-loathing that all I could do was hide or cry. On day two my abdomen would swell and a visible layer of water weight covered my thighs, back and butt. Puffy eyed and dragging with fatigue, the countdown would begin. On the third day my period would start and with it came a sense of relief. It was as if the pressure valve had opened and my emotions were restored to sanity. Hormones are a bitch!

When women get clean and sober, like men, we ride the emotional rollercoaster of early recovery. People tell us what to expect and reassure us with “You’re where you’re supposed to be. This is normal.”  What no one tells us is that we are also powerless over our hormones and that they will make us emotionally unmanageable. Usually it isn’t until we have spewed venom and insanity to a female friend or sponsor that we are asked, “Where are you in your menstrual cycle?’ To which we respond with anger. The question sounds belittling and condescending. After all, doesn’t it dismiss the validity of the feelings that have consumed us?  There’s nothing like PMS to make a woman want to argue – even if it’s to argue against the very idea of PMS.

Many of us didn’t experience PMS during our using because we were too high to notice. We were always under the influence and intuitively used substances to control our feelings – including those of PMS. I know personally, I was on the Pill from 14 to 28 and my last year using my periods stopped coming so PMS was a non-issue. I decided to remain off the Pill once I got clean because I was single and knew I’d be more apt to use condoms if I had no other birth control. Now that I was single after a monogamous marriage, I didn’t trust myself when it came to practicing safe sex – since I had no experience with it. I figured fear of pregnancy would keep me on the straight and narrow of condom use. So from day one clean, I began experiencing my natural hormonal cycle for the first time since adolescence and I had no idea what to expect.

Newcomers, it is important to pay close attention to what is going on with your body so you can make the connection between emotional unmanageability and your menstrual cycle. All it will take is 4 months of charting the patterns and you will know pretty much what to expect for years to come. The reason this matters is because when you know your period is coming and the general pattern of your rollercoaster, it is much easier to accept “oh these feelings are hormonal and not connected to real life things”. This is damage control.  This will stop you from acting out on anger, nitpicky-ness, righteousness, or from damaging friendships. It will put feelings of inadequacy and loneliness in check. When you look in the mirror and hate what you see, you’ll know you are looking through a hormonal veil of distortion and tomorrow the reflection will be much different. This will save you a lot of agony. Recovery is life on life’s terms and hormones are part of life’s terms –so until you have experience riding this out clean, they will trip you up and cause you to suffer.

The easiest way to map it is this: keep track on the calendar of when your period starts and ends. Look back at the days leading up to your period when the rage and vulnerability came, when the distorted body image came, when the bleeding started. Often early signs of PMS will appear 7-10 days before your actual period but it is a window of 3 days prior that we become lunatics (even if we hide this fact from the world). You need to list your bizarre thinking, track your emotions, and note any physical symptoms (from water weight, sore breasts, cramps, constipation, lower back ache).  You will notice that your PMS is most severe every other month.

Talk about it. Find women’s meetings where you can say when you feel like blowing your brains out or throwing people under the bus even though you know its PMS insanity. When your head wants to take you down a dark street of the mind, tell yourself – this is PMS and probably not real. This helps you to keep perspective so you don’t have to end relationships, quit jobs, or disappear from the lives of everyone you’ve ever known. Trust me – there is so much comfort in knowing that the insanity is temporary, that nothing real has changed between Monday and Wednesday other than a shift in  thinking. We are powerless over our hormones and our thinking has become unmanageable and in a few days, we will be restored to sanity. Our job is to limit the damage we cause until then.

The fantastic thing about staying clean is that we begin to have an awareness of our body and our relationship to it. It begins by observing menstrual cycles but becomes so finely tuned that you will notice when any other area is off as well – when your body is fighting off a virus or flu, when your immune system is weak, when you’re in optimum health. Recovery is a process of moving from your mind (where the disease has held power) back into your body. Without this, it’s impossible to truly experience living in the moment.

I wish every woman in recovery would talk openly with one another about their experiences with menstrual cycles, PMS, safe sex, condom use, STDS, abortions, and sex. It would save us all a lot of suffering. Sadly, these subjects don’t get enough discourse and women continue to struggle to find their way through these uncharted emotional territories  – often alone and unsupported.  In time, I will do my best to open up these topics in a very public way.

 

 

 

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Therapy & Psych Meds in Recovery

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In the early years of my recovery, a lot of my friends tested positive for HIV and the AIDS virus. I went along with all the lifestyle changes to support them. Overnight we became non-smoking, macrobiotic, vegan, aerobic-class enthusiasts reading A Course in Miracles and quoting Marianne Williamson. Considering we’d all been art-damaged, punk rock-nurtured criminals and sex-working gay & straight IV drug users, throwing ourselves enthusiastically into every possible holistic and spiritual way to heal ourselves expressed our collective desire to live. And we never missed an opportunity to laugh at ourselves. Some of our adventures in spirituality-seeking bordered on the ridiculous but we needed more miracles – the first miracle being that the desire to use drugs had left us.

Years passed, we accumulated clean time, and life-saving HIV cocktails became available. The miracle had happened. Without the threat of impending death motivating lifestyle change, some people started picking up and putting down cigarettes again, ordering steak, going from sex-abstinent to sex-abundant, opting out of cardio for yoga. Over time, we exited the self-help route and found therapy.

In recovery we continue striving to enrich our lives, our relationships with others and most importantly, our relationship with ourselves. I encourage people to seek professional help whenever needed. However, Rome wasn’t built in a day. For many addicts, learning how to live with our feelings must come before we are ready to dig deeper. We do this by staying clean, building a foundation, and gaining courage by living life on life’s terms. For others, staying clean would not be possible without healing the wounds of trauma with a professional early on. Wherever you fit in this spectrum, the combination of listening to your heart and the suggestions of those with more experience will be your guide.

Therapy is a commitment to show up and be honest so it is important that you find a therapist who is a good fit. This can be done with a little research and interviewing. You can often get names of therapists from various centers connected to organizations dealing with GLBT, Women’s Services, victims of violence or sexual abuse, sex workers, runaways etc. You can Google “therapist, your location and whatever specific issues that may concern you” and see what comes up. You can ask your doctor, ask friends about their therapists. Once you begin seeking, names will come. You can find sliding scale often connected with larger university mental health facilities, some therapists take insurance and others are cash only. Prepare questions for the first meeting – it’s okay to ask them about themselves and their practice. You will intuitively know who you feel safe with. Remember, you are building a new relationship so don’t expect an instant fix. It takes time for many of us to build trust before we are able to be thoroughly honest. This is not surgery. Healing happens over time. Therapy is really a case of “more will be revealed”. The willingness to begin is all you need to start the ball rolling toward change.

People often ask “Was it worth it?” and want to know what I got out of the experience. Often during therapy I’d be asking myself the same question. I tackled many different issues according to what was happening in my life, how I was handling situations, and feelings. For example, nothing ever seemed to get me angry yet I would cross a line (usually because I felt I wasn’t being heard) and literally see red and start swinging. I knew this was strange and wanted to know how to have a different experience. That was one reason I sought help. In retrospect, what I have gained from therapy is that I now experience my feelings as they come up. I don’t intellectualize them and I don’t check out. This has enabled me to live fully in my body and be present in the moment in my life.This had not been the case for most of my life. I numbed out feelings that either were painful or scary first with drugs and then clean with escapist behaviors. These days I wouldn’t even know where the switch was to flip it to the “off” position if I wanted to. I believe this change is definitely the key to the contentment I feel most days.

I’m going to talk for a moment about medication. Personally, I’m not against meds in recovery. I do not believe we have to suffer to prove our willingness to be clean. I also know addicts have a history of preferring a pill to hard work, that we are self-deceptive and very skilled at deceiving others. So this is my own personal philosophy on the matter. I was offered anti-depressants a number of times by my therapist. It  is her job to offer solutions – and medication is a solution. I decided to exercise, meditate and get fresh air to see if it helped first. I also pinpointed things in my life I could change (people, places, jobs) that were bringing me pain. I did the work and felt better. The depression lifted without medication. If you do not try alternative methods first, my guess is you want a pill to fix it. Now there are people who will not find relief from depression or anxiety no matter what holistic avenues they take or what lifestyle changes they make. And there are people with other mental health issues. It is important to be completely honest with your psychiatrist and to choose one who has a lot of experience working with addicts. I know a psychiatrist in NYC who believes no one needs more than 3 medications to deal with disorders common to addicts. I’ve had clients come to me who have a regiment of 8 pills a day. Since I’m not a doctor all I can do is insist they get a second opinion. Also, if you came into recovery on anxiety meds, Adderall, antidepressants and sleep medication, my question is always “Did your doctor know you were abusing drugs? The symptoms that he treated, could they have been partial withdrawal symptoms from your drug of choice?” I don’t care if you’re 30 and you have been on these meds since you were 16. It is possible you were misdiagnosed because you were using at the time. Be willing to get honest with a psychiatrist who specializes in working with addicts in recovery and trust him to evaluate you.

At the end of the day, we have to learn to be honest with ourselves and honest with mental health professionals. We have to be willing to make lifestyle changes and to heal old wounds in order to find peace and comfort in our skin if we are to stay clean and sober for the long haul.

 

 

 

 

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