The One major, legitimate critique of traditional 12-step recovery that I hear a lot (and agree with) Dogma.

Jan 04 2020

Are We Defining Treatment Success the Wrong Way?

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, Therapy, Video, Yeshaia Blakeney

Let’s face it, the media has an impact on our opinions and how we view the world. Unfortunately, seeing the world through the eyes of the media isn’t always…well, reality.

Take substance abuse treatment. Popular culture believes a person successfully completing treatment will stay away from drugs or alcohol for the rest of his or her life. As a result, life gets better. Sure this idea of success is ideal, but…

It’s not always that black and white.

Let’s say someone completes treatment and slips up some. Maybe they go out for a couple of drinks or have a weak moment with their drug of choice. But then they used what they learned in treatment to get back on track and not fall into the cycle of addiction.

Is this a success or failure?

Sure, there was relapse. But there was also a personal recovery taking place afterward. Ultimately, their quality of life did not suffer.

So treatment success may not fit into a neat little box of assumptions. Every individual comes to treatment with a unique set of circumstances. Is measuring success in a standard “popular” way counterproductive or even setting one up for failure?

Sometimes the right environment for the right amount of time can be the difference between success stories and failures. Recovery Integrity offers a long-term, all male program in Los Angeles. With a success rate of around 45%–much higher than the industry standard.

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We are Rooted in the Foundation of the 12-Steps and Believe in Long-Term Care

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Dec 15 2019

The Reality of Treatment Success Rates

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Coming to treatment has always been a hard threshold to cross – but more so now… Working in treatment for a long time, I’ve experienced greater consumer wariness.

People are more hesitant to send their loved ones to treatment and people who are looking for treatment are more hesitant to come. I think one of the reasons is the discourse about addiction, treatment and recovery has hit the mainstream, and one of the things that has come out is that the success rate of treatment is like, 15%.

But why are success rates so low? Several reasons:

– Poor treatment. Treatment that’s not set up well & doesn’t understand the various personalities of the population they’re working with and their underlying conditions and problems. Like a bad mechanic.

– Shady treatment that just isn’t trustworthy. Meaning their intention wasn’t to figure out how to help people recover. Their intention was to make money. That type of intention can be disasterous.

– The nature of addiction and recovery. The nature of addiction is… it’s chronic. It is not a problem that can be solved with an event. It’s something that has to be worked with over time.

A good analogy to understand why treatment success rates are low is to think about something like the gym. My guess is you’re going to see like ten, fifteen percent success on those goals of fitness of people who signed up for memberships. Right?

Recovery is the same way. Recovery is similar to a muscle you have to exercise consistently. Lots of people will sign up for something that they won’t follow through with. It’s the really hard part of treatment and recovery.

It’s this mysterious question of the will, why some people have the will to change certain parts of their lives and other people don’t, and honestly it’s not a place where we have good answers.

Many times we just wait for people to be ready to change, but if you have a loved one or a spouse, or kid who is – shooting heroin – you really don’t feel like you have the luxury to wait around for them to change.

So people intervene, and people are in different stages of readiness for change, and there’s not an easy solution for that.

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We are Rooted in the Foundation of the 12-Steps and Believe in Long-Term Care

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Nov 26 2019

Dogma in AA: Trusting in the Spirit of Reality

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Dogma is not actually something I would want to get rid of within Alcoholics Anonymous.

I would also say dogma is not something that I want to get rid of in alcoholics anonymous. On some level, what it means to be a person in recovery, who’s engaged in traditional 12 steps is to have some sense of acceptance, that you are not in charge of the world.

And it’s sort of like trusting the spirit of reality and they call it God’s will, right. It’s a little bit more loaded of a term, I’ll just call it the spirit of reality. Meaning, I have to accept what is. Right?

I could fight it, but I’m going to lose, because – what is. And so if what is, is there are dogmatic personalities in alcoholics anonymous, who am I to fight that?

Am I in charge of how people should be in meetings? And the answer is no, I’d be a hypocrite. Right? Am I dogmatically against people who are dogmatic? Well, no.

There’s another reason why I wouldn’t get rid of dogma in alcoholics anonymous. It’s helped a lot of people. There’s a, sort of a spectrum of meetings, there are meetings, a late-night Hollywood meeting, it’s like a comedy show fiasco. It’s totally insane and foul and people yelling. A bunch of jesters all in one space acting out. There’s no order. It’s total chaos. Great Energy. I thought I sober was gonna be boring, this meeting is wild!

And then you have very rigid (you have to wear a tie) and other groups that have developed their own culture which is much stricter, much more dogmatic, much more rule-bound, and all are helpful for a lot of people.

That kind of container and that rule of structure and not having to question everything, and just being able to take direction feels really safe, and it feels good and it helps them build lives.

So there is dogma in the personalities in alcoholics anonymous. It’s not a bad thing, and if the traditional 12-step is something that’s going to help you, there are ways for you to belong that work for you.

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Nov 10 2019

AA tries NOT to be dogmatic

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Alcoholics Anonymous

Although somewhat known for dogma – actually has gone out of the way to NOT be dogmatic.

Everything is languaged from a place of suggestion as opposed to declarative statements for how you are supposed to be.

When you see it in the literature of Alcoholics Anonymous, you notice that these were people who were not only NOT particularly dogmatic, but they were also sensitive to the fact that people would be sensitive to dogma.

I am half African-American, and when I read the core text, the Big Book of Alcoholics Anonymous, I’m shocked that the word “negro” isn’t in there.

It’s 1936, pre-civil-rights-movement. It says nothing about who can come and who can’t…

So there is dogma in the 12-steps, it’s not my cup of tea, but it largely has to do with the personalities that exist in certain meetings within the fellowship.

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We are Rooted in the Foundation of the 12-Steps as We Believe Fully in Long-Term Care

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Oct 21 2019

How to Deal with Dogma in Traditional 12-Step Recovery

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The One major, legitimate critique of traditional 12-step recovery that I hear a lot (and agree with) Dogma.

Which is basically some authority prescribing rules or structure, usually rigid or fixed rules, to a system.

You find that in AA, and for some people that’s a big turn off

I don’t like that, I’m a questioner, a doubter, I’m curious… and it doesn’t work well with me or a lot of people.

So how do you deal with this? You can choose not to participate, but maybe 12-step or traditional recovery is a huge part of what is going to help you change.

What people need is some clarity. The program itself is actively not dogmatic. It’s not hierarchical, there is nobody in charge. In order to be dogmatic, really, there has to be someone prescribing the rules.

People project dogma because they experience dogmatic personalities in Alcoholics Anonymous, and that makes sense. Often dogma comes from pain and brokenness. In response to my difficulty, I might create a whole crazy rule structure to how I have to be… …and if I go too far down that road, I might create a whole crazy rule structure about how you have to be.

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Aug 16 2019

The Rebel Side of Alcoholics Anonymous

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What to expect in this episode:

Alcoholics Anonymous is for Rebels

The other thing about Alcoholics Anonymous; addicts and alcoholics often feel rebellious inside.

There’s a rebel piece that grows inside of us during the teenage years and sometimes we have a hard time growing out of.

(…Maybe we shouldn’t grow out of it.)

I would say Alcoholics Anonymous is very rebellious.

Alcoholics Anonymous is completely disconnected from the market place

When I say its free, that’s a big deal, it also is completely disconnected from the market place. Its not only that it doesn’t cost any money to go there. There are non profits that you can go to that don’t cost money; but it actually has little to no relationship to the market place at all other than people putting a dollar in a basket to pay some cheap rent at a particular building.

SO it is totally disconnected from our economic system, and I would invite anybody to name any other institution that’s completely disconnected from our market economy. I think that’s important.

There are no commercials or advertising for it, somehow it’s just its own temple, or sacred space. It hasn’t been invaded by a lot of economic forces that we are all at the whim of. So I think there is something special about that.

Alcoholics Anonymous Hierarchy

The other thing about AA is that it’s not hierarchical, not that there is no hierarchy, it just a very flat hierarchy.

There’s nobody in charge; when you go to a meeting, there is someone leading the meeting, that rotates every 6 months based on a democratic process usually, that people vote on.

You might ask, “Who is in charge of these millions of people in Alcoholics Anonymous?” nobody knows, no one is in charge. It is people coming together to help each other in a way that has now worked for 80 years. It’s incredible to have that kind of flat hierarchy and it’s worked now through 3-4 generations of people.

That’s deep, religion is not like that, corporations are not like that, and my family is not even like that… well sometimes it’s like that…

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Jul 02 2019

The Controversial Nature of Alcoholics Anonymous

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What to expect in this episode:

The Controversial Nature of Alcoholics Anonymous

The resistance that people have to the 12 steps can be overcome.

What it takes is a person understanding specifically where your resistance is and walking you through it; allowing you to see it and understand it in a way that’s palatable for you. Showing you that in the beginning you can tolerate it and in time come to enjoy.

I’m not into force or coercion, so a person has to say, “I am open to learning about this”. For a lot of people 12 step recovery is the biggest resource they’re going to have. There are quite a few things about 12 step that are really incredible and are not replicated anywhere else as of now, in terms of support for addicts and alcoholics.

The first thing I would say that is really radical about the 12 step program is that it’s FREE. I hear a lot of critique from psychologists and psychiatrists, and honestly I don’t like it, about the 12 step program. That it’s not sophisticated enough, it’s a religion; the same critique that clients have, they parrot those (opinions) back in NPR.So I will ask, “What is your solution then, for addicts and alcoholics”? They will say CBT, which is particular therapeutic modality or DBT (another therapeutic modality), or psychiatry, etc.

That’s great, but what about the hundred million people who can’t afford to go see a therapist 3 times a week, at $120-$180 per hour in LA. What about the million people who can’t afford $400 per hour to see a psychiatrist monthly? What about those folks? What is going to be their consistent support? SO they critique it, but they don’t have another good solution in the end. If you were to ask me, “How many people do you know in recovery”? I’d say, “I know about 2500 people in recovery”. If they said, “how many of those people had a 12 step experience as a foundation for their recovery”? I’d say, “Probably about 2475”.

Now that’s not evidence that this is the only way to do it, or the only way that works, it’s the most available way to do it, so that makes sense. However, if you were to say, “Yeshaia, how many times have you seen people use an alternate route to recover successfully”? My answer would be 330-40, or something like that.

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We are Rooted in the Foundation of the 12-Steps as We Believe Fully in Long-Term Care

May 21 2019

Is Recovery Abstinence?

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What to expect in this episode:

Is recovery (just) abstinence?
You won’t be protected from relapse unless you learn to change and grow through the underlying issues
The fastest way to learn, grow, and change is to be in an immersive environment. That’s why the recovery community is so important.

Is Recovery Abstinence?

The fundamental question is: What is Recovery?

People don’t ask it because they think they know the answer, but answering that question wrong leads to heartache and tragedy for millions of families.

Recovery is not abstinence. It’s not NOT using the substance you were addicted to. If recovery was just abstinence, it would be like taking a picture of a person 3 weeks a month after they were actively using and that person if you look at them is the exact same person they were when they were using, minus the substances.

Well, that person is going to use again. WHY? Because they are the exact same person they were when they were using. As soon as you remove whatever the block is, whether its environment, commitment, things going well, anything really, they’re going to respond and behave in the same way they did before because they haven’t changed.

The way to understand recovery is to understand that it is abstinence PLUS. Not using the substance I am addicted to and perhaps even all substances PLUS learning, changing and growing. It’s the learning, changing and growing that protects me from relapse. I no longer have the same thoughts, feelings and responses that I did before; therefore I can navigate life, environment, relationships, success, lack of success, and all the stuff that comes along in life in new ways because I am continually growing. The real work of recovery is about that growth.

A deep question is: How do I do that? How do I engage in recovery and learn, change and grow?

Anybody who knows me knows that I do not think that therapy is the fastest or the most direct path to change. It’s a part of the puzzle but not the whole puzzle. I’m not a fundamentalist, I like the 12 steps program a lot, but I’m quite open-minded about how transformation happens.

I will say that an immersive experience is the fastest way to learn and grow. An easy analogy would be like learning a language. If I want to learn Spanish (I’m in California so it makes sense), how much studying am I going to have to do from a book to be able to speak Spanish? I personally took about 9 classes and I can order a burrito, taco, say hello, say goodbye, but if you drop me in the middle of Mexico I will not be able to ask how to leave.

If you drop me in Mexico and I have to live there for 3, 4, 5, 6 months, a year… through necessity I am going to immerse myself in the culture and with those people and then I am going to have to learn the language to get by, unless I actively stop myself.

I think recovery actually happens the same way, it’s learning through culture. It’s why I’m a huge fan of recovery support systems; it’s why I’m a big backer of treatment communities, group treatment. There’s something about being immersed in the culture of recovery where people are speaking the same language and we are picking up on all kinds of stimulus, not just one person working on themselves, which allows us to change and grow faster.

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We Can Help You or Your Loved One Move Beyond Abstinence into True Freedom from Addiction

May 21 2019

Developmental Disturbances within Addiction Populations

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What to expect in this episode:

Understanding areas of identity, emotion regulation, emotional awareness, cognitive ability
Jean Piaget was interested in was how human beings transform, that’s what growth is: growth is transformation.
There are developmental disturbances in every single person coming into treatment.

Developmental Disturbances in Addiction Populations

We have got these areas of identity, emotion regulation, emotional awareness, cognitive ability (my ability to think in more complex ways) that’s actually worth understanding.

There was a guy named Jean Piaget, who was one of the founders of Developmental Psychology, he was also a revolutionary biologist, a mathematician… a deep brilliant man, study Jean Piaget.

Jean Piaget spent huge parts of his life watching kids play. What he was interested in was how human beings transform, that’s what growth is: growth is transformation.

He was particularly interested in the uniform, universal ways that human beings grow, learn, change and transform in predictable periods under predictable circumstances. What he discovered was that human beings cross-culturally, and cross-gender, grow in particular ways.

For example, if you ask a 3-year-old to do multiplication, it’s not going to happen. Around 4-5 years old kids can start to add up oranges. One orange plus two oranges makes 3, 2+2 is 4, they can do addition. If you ask them to do mathematics, they actually do not have the structure of the mind, the capacity in that moment, manifested to be able to do abstract math. It doesn’t operate as easily in things that you can grab and do, in more complex abstract, mathematical terms.

That’s in every area of our life, so development is having more complex and nuanced ways of interacting and thinking about the world as we grow older. That’s cognitive development, and we have all these areas of cognitive development, emotional awareness, emotion regulation, identity… and then one that’s very rarely talked about by psychologists because it’s very controversial.

It’s at the core of being human, which is moral development. How I think about issues of right and wrong and my understanding and ability to articulate to myself why I think something is right, and why I think something is wrong. In all of these areas, we can develop uniformly, and in all of these areas, we can become disordered.

What you’ll find if you do some psychometric testing on people in the addiction population, or you do developmental testing in all of these areas, you’ll find that there are disturbances in every single person coming into treatment. My parents actually who are developmental psychologists did a longitudinal study of 700 people coming into treatment, and all 700 people had an identifiable developmental disturbance outside of the norm of the population. It’s the same kind of developmental disturbances that you see in a mentally ill population, and also the criminal population, and as we know there is a great overlap between those populations.

Part of recovery, if that’s part and parcel of addiction and developmental disorders, then part and parcel of recovery is treating those developmental disorders. First, we have to be able to identify them, people will say when somebody comes in (to recovery), clearly you’re stuck and you can almost feel people when they’re having issues and coming into treatment beyond addiction. But understanding what areas they’re stuck in is much more complex and it’s one of the areas that’s going to have massive development in treatment.

Guess what, you’re not stuck cognitively, you’re stuck emotionally, ok how do we deal with that? Guess what, you aren’t stuck cognitively or emotionally, you’re stuck in your identity and your vision of seeing yourself. These areas are well researched in the field of psychology and we even have therapeutic approaches to deal with them. What we haven’t developed well is a method to identify and then treat that in the addiction population. That’s what’s happening right now and one of the things we do in our treatment program.

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Treatment for co-occurring disorders is vital to successful addiction recovery

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