A MESSAGE FROM DR. MCDOWELL

The following article is the result of my experience on the Donwood Out-patient Department over the past one and a half years. These are clinical observations and personal impressions which have resulted. I have no research evidence to support these views and I must claim the right to change my point of view with further developing experience. I feel, however, that, for me, these observations have proved very useful and I hope they prove useful to you.

There are a number of attitudes I see in former in-patients that immediately make me feel very uncomfortable. I have come to regard these as real indicators of imminent breakdown. They are a state of mind which indicates a return to rationalization of the true practicing addict, and are often overlooked by the patient and his family.

Any information which states that the patient is not really doing anything except his job is a very prominent warning sign of trouble. It shows that the overall health plan, and the true meaning of the word "balance" has been forgotten. This patient cannot help become either bored or depressed, given sufficient time. This mental state is the seed bed for a return to the old habits of addiction. As Winston Churchill once stated - "Change is the master key. A man can wear out a particular part of his mind by continually using it and tiring it, just the same way as he can wear out the elbows of a coat by rubbing the sleeves and shoulders; but the tired parts of the mind can be rested and strengthened, not merely by rest, but by using other parts."

Another attitude which I find particularly revealing is any indication that the patient has begun to do things because of the effect he has on others. Here the individual seems to be drifting from the original "selfishness" that is so necessary to the recovering addict. It has become terribly apparent that the only real motivation which will last must come from within the individual. Otherwise, there is no true lasting happiness, even with success in abstention.

Another feeling I sometimes sense, which I feel is a real danger sign, is the loss of a dynamic feeling of life. By this I mean the individual begins to feel that by setting up a fixed organized method of living, he has solved any present or future problems. Here I feel that two major mistakes have been made. First; he has become so involved in the mechanics of living, or worse yet, he feels that these mechanics are actual living. It is very necessary to have the organized mechanics present, but there will be no real happiness unless he can really work at, and experience, the joys of living, and not just plod painfully through an organized plan of day to day existence. Secondly; this fixed plan of living, without thought or emotion, exposes the patient to any number of problems that a fixed inflexible plan does. There must be some elasticity and ablility to change the present so that one may handle the dynamic problems of life.

A final danger sign I see frequently is the inability to judge what is really important in the life of the individual himself. Here a person is very liable to become caught up in a welter of details which gradually loom so large that the overall picture is obscured, or lost. Here one must keep in mind the long term, overall picture. He must not allow himself to become impatient and short tempered over what are really inconsequential details that will, in good time, clear themselves if given sufficient patience.

These are just a few of the common problems I have seen in Donwood from day to day. I hope that, by bringing them to your attention, that it will help you to avoid some of the traps present on the road to recovery.

DOCTOR MCDOWELL

DON SAYS: Dr. McDowell was on the staff of the Donwood Institute at the time this article was written in March of 1970