(This document can be downloaded in its original form by clicking Kodiak Handouts.)
Opening Statements for Training
Dear Brothers and Sisters in Christ,
We are meeting for the next three days to address and old and a new problem in our parishes, that of alcoholism. I say “old and new” because alcoholism is a problem that has been with us for generations, and I say “new” because it affects each new generation of youth as if no-one had ever heard of it before.
The problem of alcoholism in our communities is well know about and documented. Many of the funerals, the divorces and domestic violence events, the abandonment of children, poverty, and other social problems that your parishioners face are often times related to alcohol abuse and alcoholism. Community events like weddings, funerals and baptisms sometimes focus attention on a persons drinking problem.
I would like to stand here and to tell you that we have some simple and easy solution to this very difficult and complex problem. We do not have such answers. What we are offering you are some fresh idea’s, methods, and approaches for helping people with alcoholism. We hope that you can add these ideas to your already existing methods of helping those people in your parishes that have alcohol problems.
Alcoholism is a family disease, and family members bring the problems from the home to the priest so that he can give them advice about what to do about a spouses drinking, and for moral support and encouragement. Sometimes it is the casual greeting, or informal contact with someone that gives the message that there may be a drinking problem. We hope that our program will help you to not only identify the problem of alcoholism when it exists, but also that you will have new ways with which to deal with this problem at the parish level.
Feeling Chart Outline Note
We live in a drinking culture; people learn early in life that drinking is normal.
PHASE I. LEARING TO DRINK AND TO CONTROL THE MOOD: The first drink brings pleasure. Over time the person learns to drink more alcohol for more effect. He then learns to control the mood by the amount used, and to seek the feelings.
PHASE II. SEEKING THE MOOD SWING: Occasional excessive use, but with no real emotional cost. The “return factor” stops at “normal”. Increased alcohol use over time.
PHASE III. HARMFUL DEPENDANCE: Increasing emotional cost with increased use; guilt feelings about behavior; drinks to over come guilt; decrease ego strength; progressive loss of values and belief in self; self-destructive life-style; loss of control.
x x x x x x x x X x x x x x x x x
Substance abuse in teenagers….risk factors –
- teenagers subculture: grownups are trying to control the teenagers use by associating it with a certain age, with certain social events, with ceremonies and festivities; our culture (family, community, churches) have changed their attitude to one that is not only pro-use, but also one of giving up old traditions and reducing control. Overall, the environment is only one of the ‘causes’ of teenage drinking – in other words, a risk factor. Most of the drinking doesn’t take place in the family, social or religious circumstances, but in a peer subculture. This subculture is one that is often unsupervised by responsible adults, that improvises its own rituals and that gives its own meaning to substance use. In the worst case, this ends up being a ‘caricature’ of the society, and all the caricatures are predisposed to exaggerations. Still, not all the teenagers develop addictions, so we can not totally blame the cultural factors.
- teenagers personality: by their nature, teenagers are prone to taking risks which, even if dangerous, are captivating and attractive; teenagers live ‘here and now’, much more than adults do; from a developmental perspective, teenagers are the middle distance between childhood and maturity, both biologically and cognitively (the ability to plan and foresee the consequences). From the same reason, teenagers have a difficult time in delaying the gratification (reward); drinking offers an immediate reward. It is easier for teens to move from the experimental use to the habitual one in order to feel good or to avoid feeling bad, without taking the consequences into account. In time, drinking can become the main recreation source and coping mechanism – rebellion; will power – knowing what you want and think, no matter what others want and think, can become dangerous if it develops without the planning and consequence anticipation skills; the desire for independence involves a certain opposition. The parents attitude is essential – id they are too severe, they will block the autonomy of the future adult, leaving vulnerable to peers pressure; the opposite attitude, of giving up their social and parental responsibilities, leaves the teenager without a structured set of values and traditions. In the happy case of a successful individualization process, the outcome is a mixture of parental influence, of the own culture and experience, under the sign of willpower and integrity and guided by values and ideals congruent with the social interests.
- peer pressure: a great part of the teenagers-parents conflict has to do with loyalty: parents approval vs. friends approval; teenagers are more sensitive to group rules about the way they look, their behaviors and attitudes, and most of their mood changes has to do with the struggle of winning and maintaining this approval. This subculture is one that encourages the hedonistic / instrumental substance use; if the group to whom your child belongs to, has such an attitude, he is at risk of developing a substance use and abuse problem.
- teenagers estrangement: this refers to rejecting / interrupting the connection between the teenager and the parents and society’s values, ideals, traditions; this is not without emotional consequences; the estranged teenagers are angry, they do what they do because they feel betrayed (even without really acknowledging in this way) by those of whom values they reject. In fact, each estranged teenager has been neglected by his family, society or by both.
- stress: the problem of stress needs to be seen from the perspective of coping mechanisms (the less of them an individual has, the more stressed he will be); the stress symptoms include nervousness, anxiety, irritability, agitation, sleeplessness, concentration problems, eating disorders and substance use problems as a compensation. The dysfunctional family environment is one of the main stress factors, especially where there is physical, sexual and emotional abuse, domestic violence, arrests, parental alcohol and drug abuse, mental disorders at one of the parents. Still, not all the teenagers that develop a substance use problem are coming from these kinds of families.
- insecurity and low self-esteem: self-esteem is based on the ability of overcoming the obstacles; the success strengthens the self-esteem, while failure leads to self-esteem decrease and anticipating the future failures; chronic failure and frustration ends up in despair and “learned helplessness”. Insecurity has its roots in the lack of affection, in a climate of trust in others and in himself. Both of these aspects may lead to substance use as a compensation method. Each teenager is an individual looking for something to make him feel special and proud, whether it’s personal attractiveness, talent, social skills or intelligence.
The process of addiction
- Experimental use – motivated primary by curiosity and the search for ‘high’ moods (sometimes, also by rebellion); the use effects are less important than the mood that comes along with this taboo; this use takes place usually in a social context, it’s not frequent, can be impulsive and lead to drunkenness; we can also meet the use of multiple substances.
- Social use – the primary motivation is social acceptance and social facilities (integration); the main effects are relaxation and giving up the inhibitions; this use takes place in the friends / colleagues group, at parties; big amounts of alcohol can be used, they can get drunk; hangovers and blackouts may appear; this is the stage when teenagers begin to learn about the instrumental effects of drinking on emotions and behaviors.
- Instrumental use – in this stage, the teenager searches for the previous mentioned effects of drinking on emotions and behavior; there are two types of use: the hedonistic one (searching for pleasure and giving up the inhibitions, sexual or aggressive behavior) and compensatory use (using the substance to inhibit a behavior or suppress some emotions, like anger, resentments, guilt, shame, pain, boredom or anxiety). At times, accidents, hangovers or blackouts may appear, but the negative consequences are still minimal and hard to notice. Missing school and lower school performances may result, but the adults will not make yet the connection with drinking.
- Habitual use – alcohol use becomes the main way of entertainment and/or coping with problems. Changes in the lifestyle may appear (entering a group that drinks heavily, intoxications are more often, isolation, rebellion, irritability). Also, this is the stage when we can talk about a tolerance increase (the need of progressively using more alcohol to obtain the same effect) and about maintaining the alcohol use behavior, despite the physical, social, legal, academic and emotional consequences.
- Compulsive use – loosing the control of the use (when, where, how much, for how long), preoccupation with the use, unable to stop the use; irritable and depressive when not using.
Brief Therapy and the Cultivation of the “Hidden Strengths” of the Client –
I. Our attitudes about the patient are relevant to treatment.
A. Generally, society tends to focus on the dysfunction or “problem behaviors” of the client.
1. Depression, Borderline, Low self esteem, and Dysfunctional are common terms used to describe the alcoholic.
2. When we look for such pathology, we usually find it, and then treat the patient accordingly.
B. As Counselors, we have a choice as to how we are going to view the client.
1. We can see the client in terms of pathology and dysfunction
2. In terms of “Competencies, Resources, and Strengths.
C. People will sometimes fulfill our expectation of them to be sick, and dysfunctional.
1. People will become stigmatized by us, if we have a narrow view of them
2. People are often defined by “totalizing description” of themselves
3. “Self fulfilling” prophecies of the patient are difficult to overcome.
D. “Possibility”, or “Brief Therapy” seeks out the clients strengths, and then encourages their development in daily life.
1. It is “Solution Based”, that is, helping the client to find solutions to daily problems.
2. It is “Strength Based” in that it encourages the client to use and develop their strengths and assets.
3. Oftentimes, the clients “Strengths” must be pointed out to them, as they have forgotten them.
4. These strengths are “amplified” back to the client, giving them a sense of empowerment to make further changes in their lives.
5. The Brief Therapist looks for “sparkling moments” or “exceptions”, which are times when people have been successful in overcoming their problems.
II. The “Possibility Frame”
A. Three Elements of the Possibility Frame……..Hope, collaboration, and novelty
1. HOPE……..people are often demoralized…….hope is critical to therapy
A. Ask questions that will instill a sense of hope
B. The goal is for the patient to reclaim their life.
C. Point out that change is already happening…….they are talking to you!!
D. Ask the client to describe what life would be like without the problem.
E. Ask questions that put the problem in a context that it can be solved.
F. Ask questions about past success in dealing with the problem.
G. Stress solutions, not the problem…..be goal oriented.
H. “ONE DAY AT A TIME, KEEP IT SIMPLE, EASY DOES IT……
J. The important thing is to stress past successes, and solutions
2. Build Collaboration and Cooperation in the Relationship
A. Respect the clients ability……..be empathetic, not sympathetic
B. Respect the clients right to be wrong…….and to learn slowly.
C. Let the client act as consultant………he is the customer.
D. We participate in the therapy as much as the patients does.
3. Help the patient get unstuck from old behaviors……attitudes.
A. Sometimes, they just need new ideas or a fresh perspective.
B. Often, they can generate these ideas themselves, in a counseling session.
C. Offer a fresh perspective, new idea, or alternative behavior
D. Help the client to view the situation from various perspectives.
Summary: Encouraging action puts the responsibility for change onto the client for making the small but necessary changes needed as pathways to more significant changes. It under lines the importance of behavior changes, rather than just talking about the problem.
IT: RESPECTS THE CLIENT AS AN INDIVIDUAL
IT: GENERATES OPTIMISM
IT: NOTICES THE SMALL YET IMPORTANT BEHAVIOR CHANGES
IT: INTRODUCES NEW PERSPECTIVES
IT: MAKES EACH SESSION COUNT
IT: APPLAUDS AND ENCOURAGES THE CHANGES MADE.
IT: IS STRENGTH BASED
IT: HELPS COUNSELORS NOTICE “SPARKLING MOMENTS”
IT: HELPS COUNSELORS FIND NEW PATHWAYS
IT: IS SOLUTION RATHER THAN PROBLEM FOCUSED.
Guiding Principals and Strategies in Brief Therapy
Principal: Think Small
Strategy: Set limited, achievable goals within a time frame.
Principal: Complicate situations do not require complicated solutions.
Strategy: Focus on solutions, and what works rather than on what’s wrong
Principal: Complicate situations do not require complicated assumptions
Strategy: Keep it simple, don’t’ worry about figuring everyone out.
Principal: It is the relationship of collaboration between the counselor and client that is helpful in creating an environment for change.
Strategy: Get the client involved as a partner in the counseling exchange.
Principal: Get the client to agree to achievable, specific goals
Strategy: Diagram “frame” complaints in forms that are solvable….use a flexible approach……..but be focused on the small behavioral changes. Use “Possibility Language” as a way to encourage risk taking and change.
Principal: Possibility, or Brief Therapy is works best when the client can keep it simple, doing one small change at a time.
Strategy: Encourage small changes, daily routine changes, small attitude changes, risk taking, in exploring spirituality, ect.
Principal: The family and community can help with the needed change.
Strategy: Focus on available resources in the family, and community, such as priests, friends, extended family members, psychologs.
Principal: Everything changes, including families, jobs, relationships, ect.
Strategy: Reframe difficulties as “bumps in the road”, normalize transitions as being a part of life.
Principal: Social networks are very important in creating and sustaining change.
Strategy: Involve family members in counseling as “consultants” when it is good to do so.
Principal: Maintain a sense of optimism, simplicity, and playfulness in the counseling relationship.
Strategy: Have a sense of humor and fun with the client………remember that life is not much fun if we take ourselves too seriously.
Adapted from Friedman,S., & Fanger,M.T. (1991) Expanding therapeutic possibilities: Getting results in Brief Psychotherapy.
BRIEF THERAPY AND CLIENT MOTIVATION
The “Wheel of Change”…….
- Contemplation…….am I an alcoholic? What do I do?
- Determination….I will stop, by doing these things.
- Action….specific behavioral changes.
- Maintenance…….the lifestyle change are kept in order.
- Relapse…………either in attitude, or in behavior.
- pre-contemplation does occur, outside this “cycle of change”.
- This implies that the clients “decision making process” must be considered, and where he is at in the cycle of change. Intervention is helpful, but there are cases of spontaneous remission, which do occur.
- The objective, is to avoid looking in the wrong places for the solution………if the client has found part of the answer, it is better for him, and for the counseling process, if we recognize it.
SIX RELEVANT CONCEPTS IN BRIEF COUNSELING
- DIRECT FEEDBACK is given to the client about their substance abuse. We must accurately “mirror” their behavior, and it’s effects.
- THE CLIENT IS GIVEN RESPONSIBILITY FOR CHANGE.
- WE MAY GIVE ADVICE, BASED ON THE COUNSELORS EVALUATION OF THE CIRCUMSTANCES.
- WE PROVIDE A “MENU” OF OPTIONS, AND HELP THE CLIENT EXPLORE THEM, WITHOUT MAKING HIS DECISIONS FOR HIM.
- EMPATHY IS NECESSARY FOR AND ESSENTIAL… ALL FEEDBACK MUST BE DONE EMPATHETICALLY.
- SELF-EFFICACY, OR “EMPOWERMENT” IS ALSO CRITICAL IF THE CLIENT IS TO HAVE THE HOPE AND POSITIVE ATTITUDE NEEDED FOR REAL CHANGE AND GROWTH.
- WE MUST CONSIDER THE CLIENTS CHANGE FROM ONE STAGE TO ANOTHER
- ALSO, WE MUST CONSIDER THE CLIENTS AMBIVALENCE AND VACILLATION IN THE COUNSELING PROCESS.
- TOLERANCE AND FORGIVENESS DOES NOT MEAN ACCEPTING UNACCEPTABLE BEHAVIOR, OR EXCUSING IT.
- IT DOES MEAN RESPECTING THE PERSON RIGHT TO BE WHO THEY ARE.
Key concepts in motivational interviewing
Adopted from the “CAGE Inventory” (Ewing and Rouse, 1970) the “Four Questions” can be a good way in which to organize your thoughts so that you can determine if a person has a drinking problem. These “Four Questions” are both easy to ask, and are not usually intimidating to the person you are talking to. They consist of the following four questions:
1. Have you ever felt like you should reduce the amounts or frequency of your drinking?”
2. Have you ever felt irritated or annoyed when you were criticized about your drinking?”
3. Have you ever felt bad or guilty because you drank too much?”
4. Have you ever taken a drink in the morning to steady nerves or get rid of a hangover?”
It talking with someone about their drinking habits and they answer positive to even one of these questions it means that there is a high (about 80%) probability that they will have a drinking problem. They may or may not currently be “problem drinkers”, however, an affirmative reply to any of these questions shows that there is a problem somewhere in that persons life that is related to their drinking activities.
The higher the number of affirmative answers indicates a greater likelihood of a problem already existing. For example, 89% of the persons answering positive to only two of the questions would be at high risk of already having drinking problems.
To put this in more simple terms perhaps, it would be fair to say that would be to say that if you ask a parishioner if he or she has ever tried to reduce the amount or frequency of their drinking, then you may be looking at a problem drinker. Most people do not have “cut back” on their drinking, as they never drink that much to begin with. They may once or twice, but not to the point of it becoming an issue.
Also, most people not having drinking problems will not be annoyed by someone else telling them to not drink so much. They don’t drink that much to begin with. When was the last time that your spouse annoyed you by telling you that you drink too much? Not on one occasion, but generally. With alcoholics, frequently there are problems at home related to the alcohol abuse.
Do you feel guilty about your drinking? Most people do not, but if you meet someone who does, then you are probably talking to someone with a problem. It is actually one of the more important indicators, and reflects someone in conflict with their own values. This is not a question about what someone may have done while drinking, but about the drinking itself. It is a question about who they are, and about values.
Finally, the question about the morning drink is an important indicator because it indicates abnormal behavior. Again, what is the standard? Is it normal to drink in the morning, especially to get rid of a hangover from the night before? If so, then there is clearly a problem.
Are you an alcoholic?- 20 QUESTIONS
Answer these questions as honest as you possible can!
Do you lose time at work because of your drinking _____Y _____N
Does your drinking make your marriage happier? _____Y _____N
Do you drink because you are shy towards other people? _____Y _____N
Does your drinking affect your reputation? _____Y _____N
Do you drink in a bad company or in an inferior environment? _____Y _____N
Does your drinking make you neglect your house chores? _____Y _____N
Has your ambition decreased since you are drinking? _____Y _____N
Do you feel remorse after you drink? _____Y _____N
Have you had any financial difficulties because of your drinking? _____Y _____N
Do you feel the need to drink at a certain time during the day? _____Y _____N
Do you want to drink something the next morning? _____Y _____N
Do you have problems sleeping because of your drinking? _____Y _____N
Has your efficiency decreased since you’ve been drinking? _____Y _____N
Does your drinking endanger your job or your business? _____Y _____N
Do you drink because you want to get rid of your problems? _____Y _____N
Do you drink alone? _____Y _____N
Have you had any memory loses (“blackouts”) because of
your drinking? _____Y _____N
Have you been treated by a doctor for conditions caused
by your drinking ? _____Y _____N
Do you drink in order to build your self-esteem? _____Y _____N
Have you ever been hospitalized because of your drinking? _____Y _____N
If you have answered “Yes” to any of these questions, there is an warning signal that you might be alcoholic!
If you have answered “Yes” to any two questions, there are chances that you might be alcoholic!
If you have answered “Yes” to three or more of these questions, you are definitely alcoholic!
In any of these situations, you might find it useful to talk to a specialist that could help you find more answers and information about the disease of alcoholism!
DEFINING A “SPIRITUAL DISEASE”
- The Church teaches that ‘disease’ is the corruption of something good because of its isolation from God.
- Humans were created to be good, which is why we have the natural capacity to discern right from wrong.
- Fallen Humanity is born without a natural consciousness of God’s presence.
- This leads to the experience of fear of pain (Adam and Eve in the garden first experience the fear of separation from God)
- Human nurture Pride and the dependent Passions to deal with this fear.
- Pride creates a false reality, so that its prisoner can no longer properly distinguish right from wrong. This is the core of the ‘disease concept’ of alcoholism, where the alcoholic no longer can properly rely on his intellectual functions to save himself.
- To return to reality, one must, like the Prodigal Son, return to God. This, communion with God is the cure for the disease of alcoholism, because this relationship is the only proper cure for the fear behind the disease.
- This applies to all manners of repetitive sinful behavior, not just alcoholism. Alcoholism is only a symptom of a more advanced stage of spiritual disease.
- It is necessary to note however that although alcoholism has spiritual roots and a spiritual dimension it does have very real and important physiological symptoms. Some people actually die in acute alcohol withdrawal. Post acute withdrawal symptoms that have a physiological base can last for months or even years. You could say that what begins as a sin ends as a disease and a sin.
- The recovery process is essentially spiritual, but there are physical and psychological considerations as well. Some people need a medical detox, and many will have more difficult withdrawal because of poor diet and general poor health. But the only road out of the addiction spiral is spiritual in nature.
THE SPIRITUAL PROGRESSION CHART
ALCOHOLISM AS A SPIRITUAL DISEASE: PROGRESSION AND RECOVERY –
|Alcohol sedates value system, which gets indifferent, confused||“Weller than Well” – higher levels than believed possible|
|Grandiosity, perfectionism, price||Unselfish – Goes out to others because God loves them|
|Intolerance of others: suspicion, distrust, argues||Deeper relation to God as a loving God|
|Religion getting sick: rigid, arrogant, unrealistic; disenchantment with childish idea of God||Growth in proper concept of God|
|Loses interest in life: “blues”||Prayer and meditation|
|Guilt feelings, not “at-ease” with God||Serenity, peace of soul, joy|
|Stops daily prayer; attends church out of habit or pretense||Increased tolerance of others|
|“Nobodiness” – feels estranged, alienated, lonely||Gratitude|
|Appreciation of spiritual values|
|Rebirth of ideals|
|Courage, optimism – new freedom|
|Promptly admits when wrong|
|Honesty: makes amends|
|Return of self-esteem (God not a rescuer)|
|Immaturity, some irresponsibility||False ego deflated|
|Life has no meaning||Humbly asks God to remove shortcomings|
|Anxiety, indefinable fears||Reconciliation: Personal relationship “at ease” with God (more than just “dumping garbage”)|
|Resentments: angry at God, hostile to mention of religion, projects fear into concept of God as a tyrant||Foregiveness: not “why did I?” but “forgive me”|
|Moral deterioration: dishonest, selfish||Patience: “one day at a time”|
|Loss of faith: consciously rejects God, unconsciously longs for Him – a “sick love” relation||Appreciates possibility of new way of life|
|Remorse: Depression, suicidal thoughts, impaired thinking||Trust: “Thy will be done”|
|Vague spiritual desires||Conversion: “let go and let God”|
|Gropes for spiritual meaning||Acceptance (surrender – tiebout)|
|*Second BOTTOM: “existential crisis”|
|Thirst for God examined (hard struggle for some)|
|Hope dawns: can be restored to sanity|
|New faith: “came to believe”|
|Vague notion of higher power|
|Honest desire for help|
|In spiritual fog|
|*ADMISSION (compliance – tiebout)|
|Hits BOTTOM: drinks to cope with problems of drinking|
Conference Paper on Spirituality and the Early Stages of Recovery
In helping alcoholics and addicts, there are two worlds. The one of the professional, medical or psychological level, where addiction is a brain disease, the cause is genetic and neuro-chemical, and where the hope is that a prescription will help bring about a cure. Then there is the other world, where treatment is in helping people to accept that they have a problem, helping them to review their past and helping them to hope for a better future. For most of these people, recovery will involve a personal transformation that is spiritual in nature. People who cannot accept a spiritual path should be helped in other ways.
I. The Spiritual Roots of Addiction
A. Addiction is a complex issue…bio-psycho-social-spiritual
B. Begins when someone uses a drug…why do people use drugs?
D. Lost values and a lost sense of God, Community and Self
E. We must also say that it is “Primary, Progressive, Chronic and Fatal”.
II. Addiction and Recovery are both “Spiritual” in nature because they involve the “Will” of the addict, and his value system.
Addiction…It occurs at the spiritual level when a person loses the ability to use their “volition” or “will” in a normal and healthy way. That is, they consistently make self defeating decisions regarding their addictions that harmfully affect both themselves and others. They have plenty of “will-power”, but it is misused or misdirected willpower.
”Conflict of values”, “Incongruence with the self”, and inner turmoil.
“Isolation of the addict occurs”, Loss relationships with others, God, and self.
The addict or alcoholic becomes “Restless, Irritable and Discontented” without the drink or drug to ease the cravings.
B. Recovery….It occurs when the addict regains the ability to make right choices in his life, and finds peace with his or her self and with God. The addict begins to use his “will-power” to work program of recovery.
This does not mean the addict can drink or drug again. That choice is lost forever.
Recovery implies acceptance of this fact.
He or she will no longer fight to regain control of the addiction…They become “God Dependant”, and begin to trust in His divine intervention to over come their addictions. They lose the desire to drink or drug as a way of dealing with their problems, and they begin to rely on God’s help in daily affairs.
I would also say that “Within every person is the presence of God, and the natural ability to find God’s will in real and personal way.”
III. Historical Use of Spirituality in the Treatment of Addictions
A. The Church
B. Moral Psychology: Carl Jung, Victor Frankel, William James, William Silkworth
C. Community based programs and Spirituality —12 Step Programs, AA/NA/Al-Anon
D. Minnesota Model Programs and the Clinical Adaptations of 12 Steps
VI. The Recovery Principals of AA/NA are used as spiritual guides in working with addicts and alcohol dependent people. These are the steps (1-5) that we have clinically adapted to use in the Minnesota Model, St. Dimitrie Program.
Step One: Admitting defeat; ”it’s not a problem” won’t work.
The admission of complete defeat is necessary before any real progress is possible.
It is usually proven to the alcoholic or addict only by immense experience….it is necessary to review the past and to be honest about how alcohol or drug use has affected his or her life.
Needs to accept that the “unaided will” is powerless against the first drink/drug use.
Needs to accept that the dependency only deepens as the use continues.
Until the addict or alcoholic admits defeat there is little hope for success in recovery. The program of action outlined here is just too extreme for him to accept.
This is an “ACCEPTANCE STEP”, “SURRENDERING THE ADDICTION”
Step Two: Changing the relationship with God is necessary; “Finding inner Strength, and accepting help from others.”
Some people do not believe in God.
Some people do not believe that God will help them.
Sometimes it is harder for the one who had faith, and lost it than for the atheist.
Some people are “intellectually self sufficient” and are not teachable. The addict must be willing to grow spiritually; changing attitudes and behaviors.
Some people are just disgusted with religion because of some of the members of churches, and their behavior. They do not see their own behavior, only others.
Many alcoholics become defiant, blaming God for all their problems.
In AA, it is taught that God will help the addict, if there is a working relationship developed between Him and the alcoholic or addict.
Step Three: Conforming to God’s Will.
“GOD’S WILL, NOT MINE” is the key concept in step three.
Willingness to change is the key to step three.
The decision to change must be followed by affirmative action.
There must be a recognition and acceptance of dependence on God.
It should be understood that the problem is the misuse of will-power not the lack of will-power.
In this step, the addict will ask God for help in finding His will, especially in his or her relationships with other people. He or she will need to surrender the old controlling and egotistical way living and find peace with others. He or she will need to “put God in charge” of their lives, and to stop trying to run the show them selves.
Summary of Steps I-III
There needs to be admission of complete defeat regarding the addiction.
There needs to be a surrender to the fact that God’s help is needed.
There needs to be an acceptance of God’s will, that is, willingness to do His will by accepting life style changes and inter-personal changes.
This is the point at which a dependence on God develops, and the dependence on drugs and alcohol ends. You might say that these three steps are the “Corner Stone”, of recovery. Using them is like “Building the house on rock” and they become the foundation upon which recovery is built.
Step Four: A Complete Personal Inventory is Taken
This inventory is to discover how “self-will” has dominated daily life.
Resentments are recognized and dealt with.
Forgiving others is encouraged, as is tolerance of others.
Fears are examined, and how self will and self reliance has failed.
The more glaring personality defects are exposed and examined.
Step Five: Honesty and Confession
Allows the addict to get honest in an open way with another human being.
If you are counseling this person, you need to have an understanding of what the person is trying to do before helping them with this step.
There is usually a great feeling of relief after taking this step.
Sometimes this step is taken several times before it is completed.
It should be remembered that this is not “confession” in the traditional sense, although it can be done in confession with a priest or cleric.
“This step is the beginning of a spiritual awakening… a sense of peace develops, isolation and loneliness begin to disappear, and there is the beginning of a return to a more normal frame of mind.”
The Building Blocks of Spirituality…Honesty, Open mindedness, and Willingness…The first three steps in another light.
Making a true evaluation of conditions and a willingness to face facts.
Honesty regarding having a disease called addiction. Accepting the facts about addiction, and the turning loose of arrogant, defiant and grandiose attitudes.
Personal honesty with the self regarding what behaviors and attitudes need to be changed in order to have harmony with God, self, and others.
Honesty with God about wanting and needing God’s help in order to change the old self into a new creature. This means honesty about keeping a positive focus on a program of recovery, with no turning back to the “old ways of doing things”.
To trust that God will help, as he has thousands of others.
To believe that sanity can be restored regarding addictions.
To believe in and to trust in God in a personal way.
Open mindedness about needing to have support of others in sobriety…an alcoholic alone is in trouble.
Open mindedness about new ideas and concepts, which may challenge one’s traditional ideas about addiction and recovery.
Open mindedness about being honest about changes in values to meet recovery goals.
C. Willingness to ask for and to accept the help of God.
Willingness to admit wrong, and to deal fairly with all people.
Willingness to use spiritual principals as a guide for living, the 12 Steps.
Willingness to give up old behaviors and attitudes, to adapt a new set of friends and behaviors.
D. We hope to develop “courage” in daily activities.
It is a quality of mind which allows people to meet and to deal with the problems and realities of life without reliance on alcohol.
It is the having “strength” to endure the things that cannot be changed.
It is a determination to change the things that are changeable.
It is being fearless in the practice in Humility in life, Honesty with self, and Faith in God.
Surrender vs. Compliance and the need of Acceptance for a permanent program of recovery.
SURRENDER: “For the addict, the changes in character and behavior which bring about recovery from addiction must have some meaning at a personal level if the recovery is to be long lasting. This means that the addict must find peace and serenity within his or her self if the desired changes are to be permanent.
COMPLIANCE: Without finding this sense of peace, the abstinence will be difficult, and usually of short duration. We believe that these changes are of a spiritual nature, and that any program of recovery for the addict needs to include spiritual growth as a primary objective.”
V. Some people who do not recover.
A. Those who only want to escape the immediate consequences of their addiction.
B. Those with certain organic problems.
C. Those that are forced into recovery, although they can be helped under certain circumstances.
D. Heavy Drinkers who are not alcoholics.
E. Those unwilling to accept the concept of God.
F. People who seem to be incapable of being honest with them selves.
Many of the above will recover if
They develop the capacity to be honest with themselves.
They are willing to grow along spiritual lines.
They continue to participate in programs like NA or AA.
Usually, just going to church is not enough, they need extra support.
“The key idea here is the concept of willingness to change old ideas and related behaviors that that are no longer working, and a willingness to grow spiritually.”
XI. SLOGANS OF AA AND ALANON
ONE DAY AT A TIME: In AA, alcoholics are constantly reminded that “today is the only day” that they need to stay sober. It is the “one day at a time” principal. Anyone can stay sober for one day. The key word is “Today”. As the ancient poet Omar said, “Tomorrow is unborn, and yesterday is dead. Why worry about yesterday and tomorrow if today be sweet”?. Why should we worry about the past, which we cannot change, or worry about future, which we have no control over? If we do the best we can do today, with God’s help tomorrow will be better than today. It is the fear of tomorrow and the regrets of yesterday that spoil the “now” of our existence. Our problems become more manageable if we do not pile on today the remorse or bitterness of yesterday and the burdens of tomorrow. With our burden lightened, we can find more peace in today. This is of course related to the third step, where we turn our life over to the care of God, and ask for His help and protection. We remind ourselves each morning that we will live today as fully and as God centered as we are able to do.
JUST FOR TODAY:
Just for today, I will live today only and not try to solve all of my problems all at once.
Just for today, I will not be afraid to be happy, and will not be afraid of life or of death.
Just for today, I will let be what is, and not try to arrange everything and everybody to suit me.
Just for today, I will not criticize others for what they do or for what they do not do.
Just for today, I will not find fault in others and I will forgive them for what they do.
Just for today, I will have a plan and will not hurry or rush into things.
Just for today, I will I will try not to show it if my feelings are hurt.
Just for today, I will take a little time to relax, to think about God and to be myself.
Just for today, I will turn my life and everyone in it over to God for Him to make better.
Just for today, I will do something nice for someone else, and not let it be known to anyone but God.
LET GO AND LET GOD: As I go about my day making decisions and solving today’s problems I may become irritated and tense. The fears within me can turn into a near panic. It is then that I need to “Let go” and let God work in my life. I do my part, and I leave the outcome of my efforts up to Him. He will do the things for me that I cannot do for myself.
FIRST THINGS FIRST: We do the things that need to be done first, and this brings order into our lives. We make a priority list of the “important” things that we need to do, not necessarily the one’s that are the most “urgent”. The rewards we get from doing this are a sense of accomplishment and of getting things done. It gives us a sense of value to know that we can accomplish some of the things that we have not been doing because of the extreme focus of the addiction. We do this by taking the time to slow down and to ask God to show us the most important things for us to do. For example, it is best for everyone if we keep our own integrity. This may seem selfish, but it is best for the alcoholic also.
EASY DOES IT: Wanting to accomplish too much too soon is counterproductive if we want lasting results. We may want someone to quit drinking, but pushing and controlling the alcoholic may not lead to the desired results. I also need to be easy on myself, and remember that I am also powerless over alcohol, and powerless over the alcoholic. I need to remember that even with God’s help it will take time for me find the strength and peace I need in order to live with alcoholism. I should be gentle with myself if I fall short of the ideal and lose my patience or peace. Remember that we did not get sick over night, and we won’t recover overnight either. The idea is that we are now striving to improve our lives by living with a positive spiritual direction. We expect progress but never perfection, because only God has perfection.
BUT FOR THE GRACE OF GOD: We always try to remember that the alcoholic is a very sick person, and not a bad person, or a terrible sinner. He did not choose to be an alcoholic any more than a cancer patient chooses to have cancer. We try to be thankful that we are not the alcoholic, and we try to not judge the alcoholic in a harsh or unkind way. We also encourage our family members and children to understand his disease, and to see him more as a “sick” person rather than to see him as a “bad” or uncaring person. Also, when the alcoholic is sober he will sometimes be intolerant or judgmental of his fellow sufferers who are not getting the same benefits of the AA program as he is. We can only thank God for our sobriety, and pray for the other alcoholic.
LIVE AND LET LIVE: Sometimes we think we know what is best for the other person. This is a reminder to us that perhaps our way is not for everyone. If we are going to find serenity, we must try to improve ourselves, and not criticize the rest of the world.
(Outline for Orthodox Spirituality and Early Recovery)
In helping alcoholics and addicts, there are different views about addiction and recovery. The first of these is the professional level, which is based in medicine and psychology.
- From this perspective addiction is viewed as a brain disease, and the cause is genetic and neuro-chemical.
- Here they offer the hope that a medical prescription will help bring about a cure, or through some psychological counseling insight the patient will be cured of the addiction.
Then there is the other perspective, where treatment is helping people to accept that alcoholism is a treatable disease using spiritual measures, and that the responsibility for accepting this help is with the alcoholic.
- This type of “treatment process” involves helping the addict or alcoholic to review their past, to accept the need for complete abstinence from alcohol or drugs, and in helping them to develop basic recovery skills so that they can stay alcohol and drug free.
- For most of these people, recovery will involve personal change that is spiritual in nature.
- There are other paths to recovery, but spiritual measures are the most proven method for most people who have recovered. People who cannot accept a spiritual path should be helped in other ways.
Because we are using “a spiritual approach” let’s look at some basic teachings about Orthodox spirituality.
- Here it is said that the main purpose and goal of life is unification with God and participation in His divine nature.
- The Church would also say that unity with God can only be achieved through God’s eternal Son, Jesus Christ. (John 14:6)
- Unity with the Son is perfected by and through the Holy Spirit. It is natural for the soul to seek this unity, and is the soul’s main occupation. Man cannot find love, peace in life or harmony without this unity with Christ, in and through the Holy Spirit.
- It should be remembered that from the Orthodox perspective spirituality is mostly a question of God’s action on the soul through what is called “grace” and not man’s action on his own soul, which would be more like psychology.
- Orthodox spirituality then is related to the origin of grace, and in finding grace. Finding grace is essential to spiritual growth, and grace only comes from God.
- While it can be said that grace is freely given by God, man does have his own activities in finding this grace. This is usually done through prayer, the sacraments, fasting and other common spiritual actions such as doing good works.
- It must be said again however that “grace” is a gift from God, and not something that we achieve or deserve. Our activities only help to prepare our souls for the activity of God’s gifts.
In order to achieve the unity with God that our souls strive for it is necessary that there exists cooperation between God’s activity, which is grace, and man’s will.
- It is “volition” or “will”, and not “intellect” or “emotion” that is the primary element in man’s effort at unity and harmony with God.
- This implies man’s surrender of “self will” and an “acceptance” of God’s will in his life.
- Man is dependent upon God for grace, and cannot achieve unity with God through his own efforts, no matter how great they are. It is only through divine grace and intervention that man achieves this unity.
- However, man’s own efforts and willful consent are necessary to the plan of salvation. When we select that which is good, through seeking and doing God’s will, then God gives us grace for accomplishing the soul’s desire.
- This is a willful act of “cooperation” with God on man’s part, and a free gift of grace on God’s part. We are always free to choose to do His will, and He is always free to give His grace.
- All good that we have comes from God, even our own volition. How we use the gift of our own free will is always our own personal choice.
Alcoholism at its most basic level is spiritual, in that it implies a separation from God, which is our most unnatural state.
- The mistaken use of volition which leads to addiction separates the alcoholic from God’s grace, and then the addiction overwhelms the alcoholic spiritually, mentally, emotionally and physically.
- The addict essentially becomes “powerless” over the addiction. Spiritual recovery is necessary because the alcoholic needs to move in the direction of reunification with God.
- This spiritual direction and motion was lost through the misuse of volition, which is related to the alcoholism. This change in spiritual direction can only be achieved through spiritual means, both through the use of our own volition, and through God’s freely given grace.
- The alcoholic must regain the God given direction of his soul, find his true value system”, or “belief system”, and regain the peace and harmony with God that was lost through the drinking or drugging.
Said in a different way, addiction occurs at the spiritual level when a person loses the ability to use their “volition” or “will power” in a normal and healthy way.
- That is, they consistently make self defeating decisions regarding their addictions that harmfully affect both themselves and others.
- Their choices are against their God given instincts and their souls desire to unite with God.
- They have plenty of “will-power”, but it is misused or misdirected willpower. Inner turmoil is caused by the conflict that they have with their own value system. Isolation occurs because of the lost relationship with others, God and himself.
- The alcoholic becomes lost in his own delusion and confusion and does not recognize his own condition.
Recovery occurs at the spiritual level when the addict regains the ability to make right choices in his life, and finds peace with his or her self and with God.
- The addict begins to use his “will-power” to work a program of recovery.
- This does not mean the addict can drink or drug normally again. That choice is lost forever. Recovery implies acceptance of this fact.
- He or she will no longer fight to regain control of the addiction and will trust that God will restore his sanity about drinking.
- He will become “God Dependant” and will begin to trust in God’s grace and help.
- He will lose the desire to drink or drug as a way of dealing with his problems, and begin to rely on God’s help in all of his daily affairs.
The “Bridge” between addiction and recovery is not an easy one to cross.
- In the extreme confusion of active addiction it is almost impossible for the alcoholic or addict to get honest about his condition, and to accept the fact that he needs help from others in order to recover.
- Actually, most people who do recover either report a “spiritual experience” or “enlightenment” which is closely related to a life changing event such as divorce or near death experience, or they have an intervention made by some outside person such as an addictions counselor. The help comes from outside themselves.
Of course belief in God and having faith that God can and will help him through his difficulties is certainly a good thing.
- The problem usually comes when the alcoholic confuses belief with quality of belief. Even the devil believes in God, but it does him little good.
- To recover from addiction, there needs to be a quality change in the relationship with God, and it must come from a genuine desire to change for the good, and to have harmony with God’s will.
- This requires humility before God, and surrender to God’s will in all areas of his life by giving up his own self will and ego.
- Having an open mind about recovery principles which are based in spirituality will help him to find that relationship that is missing.
There are people who do not recover from their addictions.
- Usually these are people who cannot be honest with themselves about their addiction or alcoholism.
- These are people who only want to escape the immediate consequences of their addiction.
- They may have certain organic problems related to their alcohol or drug use.
- Also, forcing people into recovery is generally not helpful, although under certain circumstances they can be helped if it is done correctly and with professional help.
There are also heavy drinkers who are not alcoholics that do not accept that they have a problem, and who refuse help.
- These people are known by their lack of guilt over their drinking behaviors.
- They simply don’t care about the consequences to themselves or to society.
And lastly, people who are unwilling to accept the concept of God, or who are unwilling to live by spiritual principles will usually not find relief from their alcoholism or addiction.
- However, many of these will recover if they develop the capacity to be honest with themselves, and become willing to grow along spiritual paths.
- It should be noted that just attending church is usually not enough. There must be a change of attitude towards their addiction, and there must be willing to grow spiritually.
- Personal honesty and a willingness to change are the two key elements of recovery.
Finding Peace with God: Steps 1-3
Recognizing our brokenness: Romans 7:15-20, Colossians 2:6-8, Ephesians 2:8-9, I John 4:1-2, Hebrews 11:1, John 8:31-32, Hebrews 11:6, James 2:26
STEP ONE: We admitted that we were powerless over alcohol, that our lives had become unmanageable.
- Admission of powerlessness goes against worldly messages of “be strong”, and “be your own master”….it is the pride of man to be “strong”.
- Goes against the addiction which is saying, “You have a high tolerance”, “you can do more”.
- This admission becomes the foundation of recovery.
- Willpower alone will only deepen the addiction.
A paradox of recovery: Only through admission of defeat can the alcoholic be victorious.
There are “Five Points” in the cycle of addiction.
- PAIN….usually caused by the addiction.
- USE OF ALCOHOL OR DRUGS TO REDUCE THE PAIN…..delusion is present during this phase which prevents the victim from seeing the reality of his situation.
- TEMPORARY RELIEF…hollow relief, avoidance, physical pleasure turns to more pain.
- NEGATIVE CONSEQUENCES……disease, divorce, job loss, spiritual crisis, ect.
- SHAME AND GUILT, WITH MORE PAIN AND LOWERED SELF ESTEEM.
There are “Two Points” which keep the cycle of addiction going.
- Fear says, “You dare not look this way”. The fear of withdrawal is real, because it can be painful and even deadly—the fear of becoming the “hole in the doughnut” is more deadly.
2. Denial, delusion, and pride are saying, “You need not look this way”, “things are not so bad”, or “I’m not that bad yet”.
Hitting Bottom: Sometimes pain becomes the great motivator for change.
- Physical…health problems, accidents, ect.
- Emotional…loss of relationships, financial, confrontation by a loved one, vocational problems.
- Spiritual….feeling of alienation from God, guilt, inner turmoil, values in conflict.
Surrendering to God and becoming God dependent frees the captives of addiction through grace, but it is necessary to maintain the spiritual position of humility regarding the addiction. There can be no going back and using it successfully..
- Surrender becomes a process rather than an event, once is not enough.
- Recognition of powerlessness over persons, institutions and situations is needed.
- It does not mean being passive, it means recognition of God’s power and our need of it.
Recovery Meditations: Matthew 9:36, 1 Corinthians 6:11-12, 10:13, 2 Corinthians 12:9-10,
Romans 7:15-25, 8:1-2, 1 Peter 4:16, Psalm 6:2-4, 31:9-10, 38:1-9, 44:15-16, 72:12-13, 88:1-3
Step Two: Came to believe that a “Power” greater than ourselves could restore us to sanity.
(Phillipians 2:13 “for it is God who works in you to will and to act according to His good purpose.”)
- After admitting defeat, a new source of “power” is needed, that is, “grace to overcome”.
- It is about the birth of faith, “If you have faith even as a mustard seed” Matthew 17:20
- It is the Orthodox tradition that each person develops an individual relationship with God.
- It can be as dramatic as St. Paul’s conversion, but usually is more like St. John of the Ladder.
Some things are needed for God’s grace to become active in our recovery.
- Abstinence from all addictive things in our lives….alcohol, drugs, sex, money, ect.
- Nothing can be allowed to become a new “god” in our lives.
- We must learn to love God through experience, and not just to agree that He exists.
- We must stop playing God ourselves, to move past being selfishness and egoism.
- We must stop putting other people in place of God.
- We must move past blaming others for our problems and self pity.
- We must have faith that God will accomplish a miracle in our life, “anything is possible if a person believes” (Mark 9:23-24)
- We must be willing to accept that it is God and not our addiction that will bring comfort, happiness and joy into our lives. (Matthew 11:28, “Come to me and ……I will give you rest.”)
- We must begin to see Jesus Christ as our source of guidance, of being our “Light” (John 12:46, “all who put their trust in me will no longer remain in the darkness.”
We must be honest about our hidden beliefs about God.
- We may have identified God with an abusive parent.
- We may have had negative experiences with the Church, or her representatives through their hypocrisy, bigotry, condemnation, dishonesty, sexual acting out, ect.
- We may be struggling with the belief that God has failed us in giving us a fair deal in life. Being brought up in a Communist country, without opportunity to leave would be a good example. Any injustice, bad luck, or ill fate could be blamed on God.
- We may be blaming God for not relieving us of our addictive diseases.
As in life generally, spiritual development is critical in all stages of recovery.
- A good starting point is in reading recovery literature, the bible, and spiritual books.
- A spiritual father is important for guidance through the steps.
- Group discussion on recovery and spirituality is very helpful in recovery.
- Recovery from addictions is dependent on building a relationship with God.
Recovery Meditations: Matthew 12:18-21, Mark 9: 23-24, Luke 13:10-13, John 6:63, 12:46, Philippians 2:12-13, Romans 10:9-10, Psalm 18:1-3, 46:1, 142.
Step Three: Made a decision to turn our will and our lives over to the care of God as we understood Him.
Step three completes the process begun in steps one and two.
- In step one there is an admission of powerlessness.
- Step two follows with the surrender of our old “gods” and a desire to change and to find a new source of “Power” and a new way of living.
- In step three the vague notion of “Power” is given over to a relationship with a “Living God” of our fathers, and we become willing to turn our will and lives over to His loving care.
This is not only a general “surrendering to God”…the paradox of step three is that the alcoholic suffers from great shame and low self esteem, while a the same time being ego centered.
- It is a daily activity of giving even the smallest activity over to God’s care.
- It means giving up the ego centered alcoholic position of self will.
- It helps to build up self esteem, and break the pre-occupation with the addiction and self.
- As the addiction pulls and pushes the alcoholic through desire of pleasure and fear of pain, recovery is looking to God in faith, and trusting in His divine plan for a better life.
The key to the door of step three is “willingness” but a decision is necessary for it to happen.
- God will do much of the work if we ask in sincerity.
- It must be a daily program, a sustained effort, not just “once saved always saved”.
- Everyone has choices, and Gods way for us must be chosen for recovery.
- It is the beginning of “God dependence” as compared to alcohol dependence.
In “Revelation 3:20” we find God standing at the door and being willing to come and to be with us, but we must be willing to hear, and to open the door so the He can enter into our lives.
The “Third Step Prayer” of AA: “God, I offer myself to Thee—to build with me as You would build. Relieve me of the bondage of self so that I may better do Your will. Take away my difficulties, that victory over them may bear witness to those I would help of they power, Thy Love, and Thy way of life. May I do Thy will always!”
- It is important to remember that this step is never completely taken, it is an ongoing process of surrender to God, and to seeking His will for the each of us.
- It goes beyond the ritual of religion, into the very heart of spirituality and into man’s personal relationship with God.
Recovery Meditations: Matthew 11:28-30, 16:21-26, Ephesians 2:8-9, Psalm 3:5-6, 23, 91:1-4, Proverbs 3:5-6
Strategies for Basic Intervention
In this section we offer basic information and advice that you can give to your parishioners who drink alcohol and who may be having problems.
.Most people who drink alcohol are not at risk for developing alcohol related problems because they drink in moderation.
However, from time to time you will have parishioners come to you asking about their drinking behaviours. They should know the risks associated with consuming alcohol and how it can affect them both physically and spiritually.
It is very important to recommend to anyone who drinks that they drink moderately.
For men, this means no more that two drinks per day.
For women, no more than one drink per day.
People over 65 should consume no more than one drink per day.
Please note that we are talking about a “drink” as being about one-half litre of beer, 250 grams of wine or 100 grams of strong liquor.
Remember that it is not about changing the “culture”, it is about prevention of alcoholism, and all of the problems that is brings into the Church.
Even though some people may not be having alcohol problems normally, under certain conditions we advise even these people to abstain altogether.
If they are pregnant or considering pregnancy or if they are taking a medication that interacts with alcohol.
Also, if they have existing medical conditions such as liver disease, hypertension or other conditions that would be complicated by alcohol use.
However, if the parishioner shows signs of alcohol dependence we encourage you to always advise them of the need for complete abstinence from alcohol.
You will already know who some of the people in your parish are who drink excessively.
They will be fairly obvious and they will already be having life problems associate with their drinking.
For others, it may not be so clear if they have a problem or not, or if they need help, or even if you can help them. The following four suggestions may help in these kinds of situations.
Suggestion One: Don’t be afraid to ask the right questions:
First of all, it is necessary to ask them how much they are drinking, and how often they drink.
- This is a normal thing to ask if they present with a problem related to alcohol use.
- Secondly, after you have a better view of what is happening to them, you are able to make an evaluation of their situation.
- Based on the evaluation that you make, you can then begin to advise them on what to do about their very real and present situation or problem.
- However, we would not stop there. Because you are the position of being the spiritual leader or your community, you will have more opportunities to discuss the problem with your parishioner, so we encourage you to continue your relationship with him and to continue to ask how his alcohol use is progressing or not progressing.
Remember, you are the “Doctor of the soul” of everyone in your parish. It should be normal for you to be concerned about their spiritual well being, and directly asking questions about alcohol use should be considered as normal if the situation calls for such questions.
Always ask about alcohol use when:
Giving normal advice about the examination of conscious for confession.
Before allowing a marriage, and during pre-nuptial counselling.
If there are problems related to alcohol, use especially in the family.
If the parishioner reports feeling guilty about their alcohol use.
Ask the simple question, “How much, and how often do you drink alcohol?”
It is normal for people to drink, and no one should be offended by such a question.
As their priest, it is important to know certain facts about such an important factor in their lifestyle if they are having problems
which are spiritual in nature
- which are in the family
- if they are having moral conflict or “guilt” about their drinking.
If they do drink, then it is important for you to know something about their use patterns even if the problems they are having are not severe yet. If your parishioner drinks any amount of alcohol and is having problems in their life then ask these questions about their alcohol consumption:
- On average, how many days per week do you drink alcohol?
- On a typical day when you drink, how many drinks do you have?
- During the past month, what is the maximum number of drinks you took on any one occasion?”
Ask “have you ever gotten drunk” on alcohol?
It is important to note that the parishioner may already have alcohol problems if
the alcohol consumption is more than 14 drinks per week
If he takes more than 3 drinks on one occasion.
For women, it is more than 7 drinks per week or 2 drinks on one occasion.
Asking the “Four Important Questions” listed below can also help when making some decisions about how to help someone who drinks, or if they need your help regarding drinking. They will give you a good idea if there are physical, social or spiritual problems related to their alcohol use.
- Have you ever felt that you should reduce the amount that you are drinking? This question is related to feelings of guilt.
- Have people annoyed you by criticizing your drinking? This is related to family and social problems related to drinking.
- Have you ever felt bad or guilty about your drinking? This is related to “inner turmoil and conflict”.
- Have you ever taken a drink first thing in the morning? Morning drinking usually means physical dependence has set in, and is a clear sign of alcohol abuse.
There is risk for alcohol problems if the parishioner answered “yes” to any one or to more of the previous four questions. Remember, social drinkers do not have the sort of problems that are mentioned in the above questions, and social drinkers do not drink to such quantities as mentioned earlier.
Suggestion Two: Consider the severity of the problem and evaluate if there is a real problem or if it is only temporary.
In asking yourself about someone’s possible problems related to alcohol use, it is useful to consider three possibilities.
- One, that your parishioner may not be alcohol dependent, but is at risk for developing problems
- Two, that he or she currently has alcohol related problems and is developing more severe problems.
- Three, that your parishioner is showing signs of what we call alcoholism or “alcohol dependency”.
Category One: those who are only “at risk” of developing problems.
These folks may perhaps be drinking too much but are not having problems serious enough to have them to consider stopping drinking altogether.
They are drinking more than moderately and they are “at risk” of developing problems later on.
They should be advised that they are at risk of developing alcohol related problems.
Later in life if these problems do arise they will be more likely to talk to you about them, because you have already given them some good advice when they were younger.
Indicators of being at risk include:
Drinking over recommended levels, as outlined earlier
Drinking in spite of having problems related to drinking.
Having a personal history of alcohol related problems.
You can also ask other questions such as:
How long have you been drinking at your current levels?
How many times a week are you now drinking?
How many times in a week or month do you drink over 3 drinks on one occasion?
What is the most alcohol that you have consumed on one occasion during the past year?
In asking these questions it is good to consider the level of denial that the person may be in, and that giving good information will help them later on.
Category Two: Those currently experiencing Alcohol-Related problems.
Signs that someone is currently experiencing alcohol related problems:
One or two positive responses to the “Four Important Questions” in the last year.
Self reports of having alcohol related personal, family or existential problems.
It is important to note the severity of the problems, and the duration of time that the person has been having problems with alcohol.
Alcoholism is a disease that affects relationships. Talk to them about their personal relationships with family, friends, neighbours, at work, or at school.
Have they been asked to stop or to slow down by a family member?
Are most of their friends also drinking, and if so, heavily?
Remember that we are only trying to determine if they have a drinking problem, if it is current, and if so how severe is the problem at this time.
Catagory Three: Those who may be alcohol dependent and who are showing clear signs of alcohol dependency:
Three or more “yes” answers in the “Four Important Questions”.
- Evidence of one or more of the following symptoms:
Compulsion to drink—-preoccupation with drinking.
Impaired control—unable to stop or moderate once drinking episode begins
- Relief drinking—drinking to avoid withdrawal symptoms
- Physical withdrawal—evidence or history of tremors, nausea, sweats.
5. Increase in tolerance—–drinking more than before to get the desired effect.
6. Decreased tolerance——-it takes less alcohol than before to get the effect.
7. Feelings of being “restless, irritable and discontented” without alcohol.
Ask your parishioner the following questions:
Do you ever feel a strong urge to drink? Do you regularly think about drinking?
Does it take you more drinks to get you high than it did a few years ago?
Does it take you fewer drinks to get you high than it did a few years ago?
Are there times when you are unable to stop drinking once you have started?
Do you change your plans from time to time so that you can get a drink?
Do you ever drink in the morning to relieve the sickness of the previous days drinking?
See “20 Questions” and “12 Questions”.
Suggestion Three: Advise Appropriate Action
State your concern as their spiritual father.
By being specific about your concerns about their drinking patterns
By being specific about how their behaviour is affected by the drinking
Advise that put themselves at great spiritual risk, just as you would for any other behaviour that is against basic spiritual wellness.
ASK: “How do you feel about your drinking?” Knowing this gives an indication of their level of awareness of their problem, and their willingness to take action if needed.
Remember the “Stages of Change” model of readiness.
Advise them to abstain if:
There is evidence of alcohol dependence or addiction.
If there is a history of repeated failed attempts at controlling the frequency of drinking.
If there is a history of problems controlling the amounts consumed.
If there is a history of problems controlling the effects of the alcohol.
If they are not yet willing to abstain completely, ask them to consider cutting down how much and how often they drink, and to consider what you are telling them about alcoholism.
If they have a problem and they agree that they need help, then help them to make a plan of action:
ASK: Are you ready to try to cut down or abstain?
Spend time with those who are willing to make needed changes and help them to develop a plan.
Remind them it is a 24 hr plan, to avoid drinking friends and situations, to stay with people close who will not encourage them to drink.
Provide them with recovery related reading materials; they are to be found at www.stdimitrie.org.
Read the same materials yourself, and then invite them to discuss the readings.
- Especially on the first visit, be sure to invite them to come again and to discuss any further problems that they may have in cutting down or abstaining. Often times the potential problem drinker will accept advice when it is based in his own experience. If he continues to have problems, he will come and see you again if he thinks that you understand him.
For parishioners who are not alcohol dependent but are at risk of developing problems later on:
Recommend low-risk consumption limits based on the guidelines that you discuss with them. Remind them that there is nothing wrong with drinking, but sometimes it does become a problem.
Advise them to set a “drinking goal”, and ask them if they are ready to consider making a mild change in their drinking habits for the sake of their spiritual well being and for the sake of their conscious. No one likes guilt.
They will respond better if they have options to consider, such as: “Some people prefer to set a limit to the amounts that they drink, and some prefer to abstain for periods of time. What do you think would work best for you?”
Provide education to your parishioners about alcoholism, and about drinking guidelines.
Ask them to think about positive reasons for cutting down or abstaining.
Ask them to examine what triggers unhealthy drinking episodes
Ask them to examine their drinking patterns in light of current problems.
Give them reading materials to help them to set healthy drinking goals.
For parishioners with evidence of alcohol dependence:
Refer them to an appropriate program for an additional evaluation.
Refer to treatment or to AA if the patient is open to going.
Involve your patient in the decision making process.
Discuss the options available.
Help them to make a good contact with someone who can help.
Some Counselling Tips:
Use an empathetic, non-confrontational style of discussion.
Offer your patients some choices about how to effect change.
Emphasize that it is the responsibility of the parishioner for changing their drinking behaviour.
Convey confidence in your parishioners ability to change drinking behaviours.
Suggestion Four: Stay involved with their recovery programs.
- Follow up with your parishioner in much the same way as you would if he had any other problem you were helping him with.
- Remember that behaviour change occurs as part of a process that often involves trial and error.
For those cutting down or doing a short term abstinence program:
Remind the parishioner that you are available if they need help.
Give your parishioner encouragement and support their efforts at change at each visit by:
reviewing their progress to date
commending your patient for efforts made
reinforcing positive change (verbal affirmations)
assessing continued motivation
Consider scheduling additional appointments if needed
Consider their motivation, and refer them to AA or to a counselling program if appropriate, even if it is for “education” about alcohol.
If they have problems remind them that for most people total abstinence is the only option that works 100% of the time. If they don’t drink they won’t have problems related to the drinking.
For parishioners who have decided to abstain from alcohol or who have been referred to a treatment program:
Keep them involved with readings, discussion of spirituality and the 12 Steps
Encourage them to attend AA meetings if possible.
Help them to make new friends, or to start and AA group in the Church.
If relapse occurs don’t be discouraged yourself and don’t let them become discouraged, it can take time.
If they are not serious be prepared to give the parishioner permission to make their own choices, but let them know that you are there to help them if they want help.
Suggestions for parishioners who need to but who are not ready to change their drinking behaviours:
Do not be discouraged about parishioners who have drinking problems, and that are not ready to change.
Sometimes change happens slowly and sometimes it does not happen at all.
By offering them advice, you have begun a process of change, and they may be taking their drinking more seriously.
Your continued love and concern for them and for their family give our Lord time to work on them.
For the “at risk problem drinker” if they are not ready to take action:
Restate your concerns about their spiritual well being.
Let them know of your willingness to help them, but only when they are ready to accept help.
Continue a friendly relationship them and with their family.
For the “Alcohol Dependent” consider these additional strategies:
Encourage them to attend AA meetings.
Advise them to consult with a professional program.
Ask them to discuss your recommendations with family members and to invite their family members to attend follow-up visits.
Advise them about the Al-anon program for family members.
Recommend a trial period of abstinence, but be careful to monitor for withdrawal and to recommend them to a medical doctor if necessary.
Most importantly remind them that:
That alcoholism is a disease.
That if they are alcohol dependent, that they may be able to control their drinking for short periods, but that it will be difficult to control it over the time.
If they are alcohol dependent and if they choose to drink that they will have ongoing problems related to their alcohol use.
That alcoholism is a primary, progressive chronic and fatal disease.
IF THEY CONTINUE TO HAVE PROBLEMS, LET THEM KNOW THAT YOU ARE THERE TO HELP THEM.
A “Relapse” is defined as a return of the main symptom of the alcoholism, to heavy drinking. Alcoholism is a disease that is characterized by relapse. In AA up to 75 % relapse at some time.
Most people who relapse do so without knowing way, or they relapse for some small reason.
There seems to be a type of phenomena called “the unaided will”……..without help from God the alcoholic has no defense, and is “powerless” to resist the first drink—or the next one. This is similar to all passions.
Before the return to the active drinking, certain symptoms can occur. These are noticeable by others by not by the alcoholic. The alcoholic becomes, “Restless, Irritable, and Discontented” until they have the relief of the alcohol. However, sometimes there are no symptoms before the relapse occurs.
Sometimes a person relapses after a time of sobriety because he believes that he can “control it”. Many alcoholics pursue this believe into the gates of insanity and death. And you cannot “unlearn” alcoholism. Until this is accepted, the alcoholic will continue to try to control his drinking.
A “return to sanity” (defense against the first drink) takes place when the alcoholic changes his relationship with God. This must be a genuine change and involves the way he thinks about his drinking, himself, and his relationships with others.
If the alcoholic fails to establish this relationship with God, a relapse will occur sooner or later. He will lack “will-power” against the first drink. However, it is not a lack of “will power” but rather “misdirected will power” that causes the problem. Most alcoholics have plenty of will power.
Once a person recognizes that he has a problem, resentments and fear seem to be the cause most relapses at this stage. The only way to get rid of them is through an honest evaluation of old attitudes and behaviors, and then making a confession of wrong doing and thinking. Failure to take this honest look at self will usually result in a relapse within the first year of recovery.
The easiest way to avoid relapse is for the person to have a “daily program” of recovery which includes prayer and meditation, a daily inventory, and being mindful of the need for recovery. This last item is best achieved through groups like Alcoholics Anonymous.
Most relapses will occur when daily prayer and personal reflection are ignored. Without the “sunlight” of prayer and meditation spiritual darkness will return, and with it comes the mental and emotional confusion which leads to the active drinking of alcohol.
Having the alcoholic to take an oath at the altar can sometimes do more harm than good. If he fails it can bring even more shame, guilt feelings, and sense of failure. This brings fear of punishment from God, even can drive the person out of the Church. We discourage such oaths. (Matthew 5:37 says “Let your ‘yes be yes’ and your ‘no be no’; all else comes from the evil one”.)
Some final thought on Relapse:
- If a parishioner relapses, be patient, he is in more pain about it than you are.
- Don’t make excuses for him, and don’t minimize the behavior. Just don’t condemn him.
- Consider that his relapse could be a time to work with him. He may be more open.
- Ask him how you can be of help.
- Encourage him to make a new resolve and to follow more closely the old ones.
- Suggest that if you were helpful to him in the past, you could be again.
Don’t expect him to ask for help. Go to him if you can and offer to talk to him again.
Intervention strategies at the parish level
- Inform your-self – read the available literature (Manual for priests and doctors, AA Big Book, Living Sober, 12 & 12)
- Take an honest look at your own believes, attitudes, prejudices and behaviors regarding alcohol use generally, regarding the local traditions and customs, but also regarding your own alcohol use.
If there is a conflict between the ideas promoted by the information program and your own behavior / believes, there are few chances that the efforts to be authentically, fully sustained and efficient. We often hear things like “I can’t talk with my priest about how much I’m drinking, he drinks more then I do” or “Do what the priest is saying, not what he is doing”. It’s our duty to make this honest self-evaluation and also to make the necessary changes in our thinking and behavior.
- Try to include periodically in your sermons ideas about the consequences of drinking (e.g. it can be a major cause of stepping away from the Church), but also include messages of encouragement, recovery, hope that something can be changed, even it seems impossible.
- Try to involve as much as possible the parish committee and council in this attempt to change the local attitude on alcohol use. Its important for them to be your “alias” in this process and not to feel threaten on their alcohol use (we all know that some trustee members of the parish have problems with their alcohol use). If one member of the council or the committee is real interested on the subject, he can get involved voluntary or can even can take some responsibilities on some action, to help the priests on extra jobs.
- Offer a positive model of behavior, even if different from the local standards – don’t accept to use any alcoholic drink at parish events (weddings, funerals). Alcohol use with the parishioners doesn’t mean that we are closer to them; we can be sociable in other ways.
- Choose a day per week to do the Akathist of the Everlasting Cup, even if only a few people are coming. The day can be chosen according to each community to be suitable, and for the priest too.
- Post on the door of the Church or on the notice board general information about encouraging people to stop drinking, the consequences.
- Prepare yourself with some flyers (1/3 of an A4 page). The handouts and litaerature you are receiving you can translate then into local language so that they become more accessible.
- In your discussions with the parishioners or in Confession (including the sermon) promote the disease concept of alcoholism, recovery programs, the idea of total abstinence. For a better understanding of the message you can use the comparison with diabetes and the need to have a sever diet on alcohol. Also is very important to promote the pastoral concepts of maintain the abstinence (as they are described by the 12 steps of AA too.)
- Invite speakers like counselors who work in specialized programs of recovery or AA speakers .
Suggestions on How to Cut Down on Drinking
If your parishioner feels like he needs to cut back on his drinking, but is not yet willing to try complete abstinence, here are some suggestions you might offer him.
I. Explore the reasons why he is cutting down. Here are some typical questions.
- Do you drink alone when you are angry or sad?
- Does your drinking ever cause you problems at work?
- Does your drinking worry your family?
- Do you sometimes drink after telling yourself that you would not drink?
- Do you sometimes forget what you did while you were drinking?
- Does drinking sometimes give you a headache or hangover?
A yes answer to any of these questions would indicate a need to either cut back or to abstain from drinking altogether. Here are some strategies for cutting back.
- Write down and discuss with your priest your reasons for cutting back.
- Set a drinking goal, that is, how much and how often you will drink. Keep in mind that normal drinking limits are no more than 3 drinks per day for men, and two drinks per day for women.
- Don’t keep too much alcohol at home.
- Drink slowly.
- Have some periods of complete abstinence from alcohol, for a week or two.
- Learn how to say no to drinking, at parties, when you are guest, or with friends.
- Avoid people who give you a hard time about your not drinking.
- Stay active, do something else with the time and money that you spend on drinking.
- Get support. Talk to you priest, your wife, your doctor and others who would be supportive of you efforts.
- Avoid places that are likely to cause you to want to drink. This includes bars, restaurants where mostly liquor is served, friends who drink a lot, and activities that are usually associated with drinking.
- Above all, don’t give up trying to reduce or to cut down. Remember that you can always give it up for good if it causes you too much of a problem. Many others have quit just because it was too much trouble to drink.
We suggest that if drinking continues to be a problem that you talk to your priest about how to stop altogether. He will know other people who are in the same situation and he will know how to help.