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
Monday, February 16, 2009
THAT EMPTY FEELING
For many centuries, it has been well known that poorly fed animals are poor workers. In spite of this knowledge, man is reluctant to correlate his own inefficiency with diet. Farmers take great care to ensure that the feed their cattle receive contains the exact percentage of protein for maximum growth; but how many of us take the effort to plan our nutritional needs to provide optimal output.
In their search for food, animals are guided by instinct. If humans have this instinct, it is soon altered during infancy by a formulation of eating habits which are determined by many factors. The availability of food, the economics of the family and community, the ethnic and religious traditions, the discipline of the home, and the pleasant and unpleasant experiences associated with food are but a few of the reasons for our food preferences. This conditioning process can make food selection unreliable unless there is a conscious awareness and interest in what we should eat. If we wait until our body tells us we need fuel to keep going, it may be too late. For many of us, this "empty" feeling has been associated with having a drink. If we find ourselves skipping meals, take it as a warning signal and ask ourselves - why am I skipping breakfast?" or "Why am I not taking time for lunch?"
Our custom of eating three meals a day is based more on convenience than physiologic need. There may often be times when meals are as much as six hours apart during the day.
Experience in industry has shown the value to worker productivity of additional rest periods particularly when associated with food. The view is widely held that between-meal snacks increase work performance and lessen fatigue.
Since fatigue often results from an inadequate or irregular protein intake, complete protein should be included in each meal. In fact, a good rule of thumb is to take a complete protein meal every four hours during the working day to help keep the blood sugar level fairly constant and help maintain a feeling of well-being.
A good between-meal snack is milk; the carbohydrate in milk (Galactose) is absorbed into the blood stream rapidly to give quick energy, and the protein in milk has a much slower rate of absorption to provide "staying power".
The need for protein is especially important at breakfast; as nearly fifteen hours may have elapsed since the last meal, and in many cases lunch is another five hours away. "Have a good breakfast"is a popular cliche often ignored today, even though most people realize that the missed breakfast results in decreased efficiency during the late morning hours. Research has shown that subjects do significantly more work when dietary regimen includes an adequate breakfast than when it is omitted. Data also seems to indicate that an adequate breakfast is better economy as far as capacity to do work is concerned than the substitution of a mid-morning break.
A conventional breakfast of fruit, cereal, bacon and eggs is good; but for some of us there are other ways to make breakfasts more enjoyable and tolerable.
As I am mostly concerned with the protein content of your breakfast, I will discuss only this aspect. Milk can be taken by itself, on cereal, in an eggnog, instant breakfast or milkshake. Eggs can be poached, scrambled, boiled , fried, hard-cooked, whipped in an omelet, blended into an eggnog, or used as a dip for French toast. Any meat you desire is acceptable as a breakfast food; bacon, pork sausages, ham, steak, kidneys, chops, beef sandwiches, or sliced chicken sandwiches. Sliced processed cheese can be placed on bread and broiled until golden brown; cheddar cheese is great with biscuits; cottage cheese and fruit are a fast, nutritious combination.
Be daring some morning and try an English breakfast of kippers herring!
You may ask; "but when I am not hungry why should I bother eating?" This is the time to ask yourself; "why am I not hungry?" Take it as a warning of some other feeling and eat something!
ELIZABETH SNELL
DON SAYS; Elizabeth was on staff at the Donwood Institute in October of 1970 when this was written. She was in charge of the food end of things, but I don't recall her title. Her message of proper eating for the alcoholic is very relevant to me. I can recall that when I was drinking, I often missed meals, and made up for it by gorging. This is not healthy, and we as alcoholics must watch our eating habits closely. This was a good and realistic article.
In their search for food, animals are guided by instinct. If humans have this instinct, it is soon altered during infancy by a formulation of eating habits which are determined by many factors. The availability of food, the economics of the family and community, the ethnic and religious traditions, the discipline of the home, and the pleasant and unpleasant experiences associated with food are but a few of the reasons for our food preferences. This conditioning process can make food selection unreliable unless there is a conscious awareness and interest in what we should eat. If we wait until our body tells us we need fuel to keep going, it may be too late. For many of us, this "empty" feeling has been associated with having a drink. If we find ourselves skipping meals, take it as a warning signal and ask ourselves - why am I skipping breakfast?" or "Why am I not taking time for lunch?"
Our custom of eating three meals a day is based more on convenience than physiologic need. There may often be times when meals are as much as six hours apart during the day.
Experience in industry has shown the value to worker productivity of additional rest periods particularly when associated with food. The view is widely held that between-meal snacks increase work performance and lessen fatigue.
Since fatigue often results from an inadequate or irregular protein intake, complete protein should be included in each meal. In fact, a good rule of thumb is to take a complete protein meal every four hours during the working day to help keep the blood sugar level fairly constant and help maintain a feeling of well-being.
A good between-meal snack is milk; the carbohydrate in milk (Galactose) is absorbed into the blood stream rapidly to give quick energy, and the protein in milk has a much slower rate of absorption to provide "staying power".
The need for protein is especially important at breakfast; as nearly fifteen hours may have elapsed since the last meal, and in many cases lunch is another five hours away. "Have a good breakfast"is a popular cliche often ignored today, even though most people realize that the missed breakfast results in decreased efficiency during the late morning hours. Research has shown that subjects do significantly more work when dietary regimen includes an adequate breakfast than when it is omitted. Data also seems to indicate that an adequate breakfast is better economy as far as capacity to do work is concerned than the substitution of a mid-morning break.
A conventional breakfast of fruit, cereal, bacon and eggs is good; but for some of us there are other ways to make breakfasts more enjoyable and tolerable.
As I am mostly concerned with the protein content of your breakfast, I will discuss only this aspect. Milk can be taken by itself, on cereal, in an eggnog, instant breakfast or milkshake. Eggs can be poached, scrambled, boiled , fried, hard-cooked, whipped in an omelet, blended into an eggnog, or used as a dip for French toast. Any meat you desire is acceptable as a breakfast food; bacon, pork sausages, ham, steak, kidneys, chops, beef sandwiches, or sliced chicken sandwiches. Sliced processed cheese can be placed on bread and broiled until golden brown; cheddar cheese is great with biscuits; cottage cheese and fruit are a fast, nutritious combination.
Be daring some morning and try an English breakfast of kippers herring!
You may ask; "but when I am not hungry why should I bother eating?" This is the time to ask yourself; "why am I not hungry?" Take it as a warning of some other feeling and eat something!
ELIZABETH SNELL
DON SAYS; Elizabeth was on staff at the Donwood Institute in October of 1970 when this was written. She was in charge of the food end of things, but I don't recall her title. Her message of proper eating for the alcoholic is very relevant to me. I can recall that when I was drinking, I often missed meals, and made up for it by gorging. This is not healthy, and we as alcoholics must watch our eating habits closely. This was a good and realistic article.
Saturday, February 14, 2009
WHAT ABOUT AA?
This question was very frequently put to patients in the Donwood Institute, and is often asked by the same patients themselves. What is AA?
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem, and help others recover from alcoholism.
The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership. They are self-supporting
AA is not allied with any sect, denomination, politics, organization or insttitution; does not wish to engage in any controversy, neither endorses or opposes any causes.
Their primary purpose is to stay sober, and help other alcoholics to achieve sobriety.
My first and important conclusion is that AA works. I can't say for sure that it works for everyone, but there are about one million people, many of whom were hopeless alcoholics caught up in the nightmare of uncontrolled drinking who are leading sober, useful lives in the fellowship of AA.
My second observation is that anybody can stop drinking, but it may only last an hour, or a day or so. The problem is to stay stopped, and to learn to live comfortably-and to this end we need help.
The program of AA is available across the continent, and over one hundred meetings are availablem weekly in Toronto. AA serves as a successful continuing therapy, teaching us a philosophy of life-how to cope with ourselves, and the people and forces around us on a daily basis, one day at a time.
In AA there are knowledgeable people, many with long-term sobriety who can help us with the recovery process, and perhaps one may fill our need for a"sponsor", a special person to whom we can relate, have respect for, trust in, and be close to-especially in the early days, weeks and months. Hopefully in time we, having received this kind of help are prepared to do the same for a new person coming along.
Some pre-judge AA - that it is composed of the worst kind of skid-row drunks - that they are hung up on God and religion, and that they are a bunch of "Bible-thumping" crusaders, etc. etc. There may be a very small percentage of people like this but the large majority represent a cross-section of all society.
I have met doctors, lawyers, cab drivers, laborers, agnostics and atheists, politicians, merchants, salesmen, writers, actors, athletes - fat, thin, black, white, yellow, old and young, bad and good (the good far outnumber the bad) - all kinds are there. Take your choice! Try a few groups until you find one you like - then get busy.
Remember, the "only" requirement for AA emembership is a desire to stop drinking. What have you got to lose? only your life!
ANONYMOUS
Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem, and help others recover from alcoholism.
The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership. They are self-supporting
AA is not allied with any sect, denomination, politics, organization or insttitution; does not wish to engage in any controversy, neither endorses or opposes any causes.
Their primary purpose is to stay sober, and help other alcoholics to achieve sobriety.
My first and important conclusion is that AA works. I can't say for sure that it works for everyone, but there are about one million people, many of whom were hopeless alcoholics caught up in the nightmare of uncontrolled drinking who are leading sober, useful lives in the fellowship of AA.
My second observation is that anybody can stop drinking, but it may only last an hour, or a day or so. The problem is to stay stopped, and to learn to live comfortably-and to this end we need help.
The program of AA is available across the continent, and over one hundred meetings are availablem weekly in Toronto. AA serves as a successful continuing therapy, teaching us a philosophy of life-how to cope with ourselves, and the people and forces around us on a daily basis, one day at a time.
In AA there are knowledgeable people, many with long-term sobriety who can help us with the recovery process, and perhaps one may fill our need for a"sponsor", a special person to whom we can relate, have respect for, trust in, and be close to-especially in the early days, weeks and months. Hopefully in time we, having received this kind of help are prepared to do the same for a new person coming along.
Some pre-judge AA - that it is composed of the worst kind of skid-row drunks - that they are hung up on God and religion, and that they are a bunch of "Bible-thumping" crusaders, etc. etc. There may be a very small percentage of people like this but the large majority represent a cross-section of all society.
I have met doctors, lawyers, cab drivers, laborers, agnostics and atheists, politicians, merchants, salesmen, writers, actors, athletes - fat, thin, black, white, yellow, old and young, bad and good (the good far outnumber the bad) - all kinds are there. Take your choice! Try a few groups until you find one you like - then get busy.
Remember, the "only" requirement for AA emembership is a desire to stop drinking. What have you got to lose? only your life!
ANONYMOUS
DISCIPLINE IN RECOVERY PART 2
Let's go back and take another look at Part 1. Let's see how much effort was made to initiate some degree of self-discipline, and try to recognize the effort for its real worth.
It seems to me that this is most important. To acknowledge self-effort, however slight, and to be aware of the positive reaction to that effort. This is the foundation upon which we rebuild self-confidence and a sense of self-worth. So let's take a realistic inventory.
After five, ten, or twenty years of encasement in the emotionally blunting isolation of chemical dependency it does take self-effort, some sense of self-discipline to enter treatment, to overcome our fears, to admit our past failures, to be able to say "what have I got to lose?"; to move from the rigidity of defence, to hear another point of view, to seek knowledge with openness ; to risk reaching out to others as equals, to learn from the knowledge and experience of others.
Not bad! But we must not stop. What comes next?
SELF DISCIPLINE
It is here, I think, that our self-discipline is tested most severely. It is hear that we must make a decision - a decision based on a mere four weeks of experience at the Donwood - a decision that will decide the course of our lives.
The facts have been presented. The damages have been assessed. The hazards have been outlined. The past has been fully explored and yet only a small sampling of the possibilities of the future has been experienced.
On evaluation of this apparently one-sided experience, a decision to reverse a way of life of ten or twenty years must be made - a decision to structure a life free of chemical dependency. It takes guts; it takes will power. It is a discipline of faith, because we do not know what lies ahead!
Ahead we find new dimensions of discipline will come to be known to us. Its character will gradually change and we will become more comfortable with it.
In the beginning it is almost harsh. It forces us to accept responsibility for our own sobriety. It dictates pursuit of new or long-neglected habits of health. It commits us to participation in a two year recovery program. It is demanding.
It is objective. It will not put up with pointless argument where there is but one answer. It pushes aside the destructive rationalization of defensive thinking. It rejects procrastination. It is truthfulness.
It is thoughtful. It gently leads us to an increasingly balanced awareness of our most intimate selves. It nudges us towards self-improvement. It helps to feel for others-balancing our too ready tendency to feel only for ourselves. It is understanding.
It is inquisitive. It leads us to explore new and healthful ways to deal with old problems. It searches out a more meaningful relationship with others. It pushes us to look again at old interests and more important, to explore new ones It requires the nourishment of stimulation and involvement. It is ever-active.
In its sum, it is responsible. It urges us to full participation in life-with courage, meeting problems; with thankfulness, experiencing rewards. It is guided by values. It knows both love and respect. It balances concern of self and others. It is alive and eager. Its reward is happiness.
"Responsible behaviour" is the root, not the result, of happiness".
MIKE WILSON
DON SAYS: Mike was on staff at the Donwood Institute at the time this article was written in April,1974. It is clear, well written, and tells us that we have to marshall our strongest mental forces to overcome the incidious effects of alcohol upon we who are alcoholics.
It seems to me that this is most important. To acknowledge self-effort, however slight, and to be aware of the positive reaction to that effort. This is the foundation upon which we rebuild self-confidence and a sense of self-worth. So let's take a realistic inventory.
After five, ten, or twenty years of encasement in the emotionally blunting isolation of chemical dependency it does take self-effort, some sense of self-discipline to enter treatment, to overcome our fears, to admit our past failures, to be able to say "what have I got to lose?"; to move from the rigidity of defence, to hear another point of view, to seek knowledge with openness ; to risk reaching out to others as equals, to learn from the knowledge and experience of others.
Not bad! But we must not stop. What comes next?
SELF DISCIPLINE
It is here, I think, that our self-discipline is tested most severely. It is hear that we must make a decision - a decision based on a mere four weeks of experience at the Donwood - a decision that will decide the course of our lives.
The facts have been presented. The damages have been assessed. The hazards have been outlined. The past has been fully explored and yet only a small sampling of the possibilities of the future has been experienced.
On evaluation of this apparently one-sided experience, a decision to reverse a way of life of ten or twenty years must be made - a decision to structure a life free of chemical dependency. It takes guts; it takes will power. It is a discipline of faith, because we do not know what lies ahead!
Ahead we find new dimensions of discipline will come to be known to us. Its character will gradually change and we will become more comfortable with it.
In the beginning it is almost harsh. It forces us to accept responsibility for our own sobriety. It dictates pursuit of new or long-neglected habits of health. It commits us to participation in a two year recovery program. It is demanding.
It is objective. It will not put up with pointless argument where there is but one answer. It pushes aside the destructive rationalization of defensive thinking. It rejects procrastination. It is truthfulness.
It is thoughtful. It gently leads us to an increasingly balanced awareness of our most intimate selves. It nudges us towards self-improvement. It helps to feel for others-balancing our too ready tendency to feel only for ourselves. It is understanding.
It is inquisitive. It leads us to explore new and healthful ways to deal with old problems. It searches out a more meaningful relationship with others. It pushes us to look again at old interests and more important, to explore new ones It requires the nourishment of stimulation and involvement. It is ever-active.
In its sum, it is responsible. It urges us to full participation in life-with courage, meeting problems; with thankfulness, experiencing rewards. It is guided by values. It knows both love and respect. It balances concern of self and others. It is alive and eager. Its reward is happiness.
"Responsible behaviour" is the root, not the result, of happiness".
MIKE WILSON
DON SAYS: Mike was on staff at the Donwood Institute at the time this article was written in April,1974. It is clear, well written, and tells us that we have to marshall our strongest mental forces to overcome the incidious effects of alcohol upon we who are alcoholics.
DISCIPLINE IN RECOVERY
Norman Barr, psychiatrist and reality therapist, says in a recent article "Responsible behaviour is the root, not the result of, happiness. Responsible behaviour means fulfilling one's needs for love and worth, without hurting others in the process.'
Two things about this quotation strike me most forcefully. First, it is a two sentence representation of a formula for recovery from chemical dependence.
Second, by the very nature of its suggested direction, it requires of the recovering patient an uncommonly, even frighteningly, high degree of self discipline. At time of treatment it seems almost impossible!
What then? How does this thing get started? How, when I have tried so many times in the past to exercise self-discipline, made promises to myself and to others and failed so miserably, can I be expected to produce such discipline now? The answer is I can't - except gradually. I must learn.
The first step in the new direction may be nothing more than a slight shift in attitude. A departure from my old rigid position that might allow me to say "These people seem to be saying that there is another way, that I can find it, and that they can help me find it. Maybe I should listen - What have I got to lose?"
Not much of a move but it is a beginning. I have more to learn, and to learn I must listen. I must try.
I must try, first, to let go of my preconceived ideas; to make a conscious effort to loosen my defences; to accept, even if grudgingly , that other points of view do have validity.
I must try to cooperate and to follow the suggestions of the staff; to get as much as possible from the tapes and films, and discussions; to question with sincerity, not for the sake of argument.
Perhaps most difficult of all, I must try to be a participant in group therapy. Not to just sit there saying to myself "I'm not like the rest of these people - none of this applies to me." To try to see that, in fact, I am much like they are, but that I find it hard to trust - to say what I really do feel. To keep on trying.
Planning - I must make the effort to set down for myself some guidelines to help me in this rather frightening transition period. Maybe to accept, at least on a trial basis, some of the suggested ways and means of making this thing work. I am an expert in the "before" aspect of this treatment business but maybe I'll need help in the "after" side of things. There certainly are a lot of people available to me - can I risk asking for their help. Can I accept their help? I can try!
I am about to be discharged. How do I feel? Frightened, certainly, but somehow I feel good about it too! What has happened? Why do I feel different somehow?
Sure I've been helped - everybody in the hospital has at least tried to help in some way. For that I am grateful. Have I tried to help? Not much maybe, but somehow I am aware of an effort on my part - I want tthis thing to work.
Not much? It's a start.
MIKE WILSON
DON SAYS: Mike wrote this while on staff at the Donwood Institute in March of 1974. His views and ideas are quite interesting. See "Discipline in Recovery Part 2".
Two things about this quotation strike me most forcefully. First, it is a two sentence representation of a formula for recovery from chemical dependence.
Second, by the very nature of its suggested direction, it requires of the recovering patient an uncommonly, even frighteningly, high degree of self discipline. At time of treatment it seems almost impossible!
What then? How does this thing get started? How, when I have tried so many times in the past to exercise self-discipline, made promises to myself and to others and failed so miserably, can I be expected to produce such discipline now? The answer is I can't - except gradually. I must learn.
The first step in the new direction may be nothing more than a slight shift in attitude. A departure from my old rigid position that might allow me to say "These people seem to be saying that there is another way, that I can find it, and that they can help me find it. Maybe I should listen - What have I got to lose?"
Not much of a move but it is a beginning. I have more to learn, and to learn I must listen. I must try.
I must try, first, to let go of my preconceived ideas; to make a conscious effort to loosen my defences; to accept, even if grudgingly , that other points of view do have validity.
I must try to cooperate and to follow the suggestions of the staff; to get as much as possible from the tapes and films, and discussions; to question with sincerity, not for the sake of argument.
Perhaps most difficult of all, I must try to be a participant in group therapy. Not to just sit there saying to myself "I'm not like the rest of these people - none of this applies to me." To try to see that, in fact, I am much like they are, but that I find it hard to trust - to say what I really do feel. To keep on trying.
Planning - I must make the effort to set down for myself some guidelines to help me in this rather frightening transition period. Maybe to accept, at least on a trial basis, some of the suggested ways and means of making this thing work. I am an expert in the "before" aspect of this treatment business but maybe I'll need help in the "after" side of things. There certainly are a lot of people available to me - can I risk asking for their help. Can I accept their help? I can try!
I am about to be discharged. How do I feel? Frightened, certainly, but somehow I feel good about it too! What has happened? Why do I feel different somehow?
Sure I've been helped - everybody in the hospital has at least tried to help in some way. For that I am grateful. Have I tried to help? Not much maybe, but somehow I am aware of an effort on my part - I want tthis thing to work.
Not much? It's a start.
MIKE WILSON
DON SAYS: Mike wrote this while on staff at the Donwood Institute in March of 1974. His views and ideas are quite interesting. See "Discipline in Recovery Part 2".
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