25 December 2014

Christmas verse 2014

This verse refers to: Nakken, Craig (2000), Reclaim Your Family from Addiction: How Couples and Families Recover Love and Meaning. Center City, MN: Hazelden.

I here present your Christmas gift,
A book on which I’m sold;
In hopes you will make time to sift
Its waters for the gold.

From its title do not fear
That you have been confused
With those who can’t stop drinking beer
Or have hard drugs abused.
The author outlines principles
By which we all may thrive.

Belief that we’re invincible
May help us to survive.
But here we learn how power
Shapes our interactions;
For if we wish to flower,
We turn down the distractions,
Such as needing to be right,
To feel less or feel more than,
To step back from the fight.
For those who mind the score can
Only find more misery

In certain isolation.
The route to our serenity
Involves recalculation
Of coordinates we entered
Into our GPSes
As we become less centered
On certainties than guesses.

Nakken sums up all he knows
Of human inner workings,
Helping each of us expose
Assumptions that be lurking
Which keep our happiness at bay,
Keep us codependent,
From understanding how we may
Live a life transcendent.

The process of recovery,
As in this book presented,
This miraculous discovery
By addicts was invented.
Us normals did not need it,
Or so it was I thought,
Till having to concede it
May be the best we’ve got.
When next I come to visit,
And your bookshelf inspect,
To see if you exhibit
This tome out of respect,
Prepare yourself to tell me,
When n’ere it may be found,
That charity compelled thee
To give somebody bound
By chemical dependency,
His friend, her family member,
This manual for ascendancy
That comes through our surrender.

Jeffry, December 2014

15 December 2014

Alignment between the MAC Program and my Personal and Professional Growth

I cannot recall a consistently happier time in my life than the present. I am being given the opportunity to exercise a wider range of my skills than ever before. Acceptance of limits in some areas has afforded new freedom in others. I seek the help of the MAC program to channel this transitionary energy into vocational stability.

The more responsible we become, the more options we create, and the more power and freedom we gain (Nakken, 2000, p. 45).

All my life I have had a cloying feeling I should be working in a helping profession. My mother was—and still is, to some degree, as she approaches ninety—a psychiatric social worker. My father fostered in me facility with the written word. He also offered a model for leading groups—for he seated his prep school English class in a circle and imposed the rule, “No one speaks twice till everyone has spoken once.” Both parents encouraged me to follow my heart—perhaps more accurately described as following whatever stimulated the most dopamine in my brain—which proved to be music. While their marital squabbles cast me in the child-inappropriate role of “peace-maker,” I was probably more successful in bringing peace to the family through my classical guitar practicing. I observed and sought to understand my parents’ issues getting along so that I might steer a course toward greater harmony in my future life.

Taking personal responsibility . . . means that we must help, mainly by example, others in their struggles to get closer to . . . principles [of betterment] (Nakken, 2000, p. 45).

Even though my primary focus as an undergrad was on the creation and performance of music, I had developed a social conscience that prompted me to get trained and certified as an elementary school music teacher. It was another thirteen years before I pursued work using that certification—as it fell in my lap throughout my early adult life to teach guitar lessons in various locations (to “support my habit” as performer and composer). When my first marriage gave rise to a move from Boston to Western Massachusetts, I had to start afresh, and began a series of episodes teaching in preK-12 classrooms. My social conscience, having spawned my activism in social causes, reasoned that I was making the world a better place through offering students artistic skill and discernment. How could people with art in their souls exploit and defile the earth and its peoples? But while it was more stimulating leading groups of young people in song than it was giving individual lessons, it was also more stressful. Conflicts I experienced with administrators—appearing in retrospect to stem from a difference in values—along with the resulting difficulty getting hired for new situations caused school music teaching to seem less and less what I was meant to do. Today, all the same, I am thankful for my experience implementing curriculum, while managing student behavior, in my work as a treatment group leader.
Apart from what I did for a paycheck, I always sought to better understand human nature. I kept an ear out for the better idea that would lead me away from inner misery and toward greater compassion for and knowledge of myself and others. Somewhere, miles away, my second wife was doing likewise. As God would have it, she and I did not meet until I was 45. She then determined, from lay sermons I had posted at my website, that I had done a fair amount of work on myself (“for a man”) and merited serious consideration. This inner work I credit to Re-evaluation Counseling, psychotherapy, a smattering of New Age modalities, and Christianity.

When we allow our higher, or spiritual, principles to be our ultimate authority, we participate in our own ego transformation (Nakken, 2000, p. 47).

I have been bestowed a unique skill set, along with a unique collection of passions, and am now being called to be more of who I am. During my years in the classroom and the private teaching studio I sought to bring out the best in students. Only a certain percentage of them demonstrated or developed musical aptitude. I often found myself wishing I could expand my role, beyond the confines of music instruction, to directly address my students’ emotional issues. Around twenty years ago, a few friends suggested that I should consider becoming a professional counselor. A short time later, a family therapist we were seeing encouraged me with his story of going for an MSW after working construction some 20 years. It was not until two years ago that I began a serious effort to manifest this idea. 
Attending Tacoma Community College brought me in closer contact with a segment of society I grew up mostly separated from. The experience brought a feeling of “coming home to my people” and prepared me to interact more comfortably with those who experienced less privilege than I. I felt a new surge in resonance with the Gospels of Jesus. As I further engaged the Twelve-Step program, through teaching treatment groups and Al-Anon membership, I came to identify with Bill Wilson’s discovery that ongoing sobriety depends upon reaching out to others. Though I have never been chemically dependent, I have come to understand that my emotional sobriety, as well as spiritual growth, are contingent upon my taking an active role in the healing of others. When one has something that would benefit others and does not share it, the soul aches.
I began with the chemical dependency focus because I needed to “get my feet wet” in Human Services and CDP looked to be a shorter route than MSW or MHC. It was only after working for a time at Recovery Centers of King County that I could envision deriving satisfaction and developing competence, and thereby overcame my fear of working in a non-music profession. As with music teaching, however, my operating range is limited. My CDP boss admonishes, “We don’t do mental health!” Of course, we do—much as a neighborhood auto mechanic attempts to do the specialized work of a dealership. 
How might I best assist this client in front of me to heal this hindrance to his or her well being? The tools of CD provide a great start, but I want every tool I know laid out on the workbench—and to get the old tools sharpened or updated. Additionally, the low pay scale for CDPs and changes in public health funding have prompted my supervisors to recommend that their counselors enter the mental health field. I still need perhaps 400 hours of client-contact time to complete CDP licensure requirements. 
How, then, does the MAC program fit my objectives? I am enrolled in Psychopathology for the upcoming term to cover the one WAC competency not included in my TCC Human Services Certification. Spring semester will improve my commute, as it puts my two courses, along with therapy at the SMU Counseling Center, on one day, reducing my weekly SMU drive time from four hours to one. I initially thought to work toward MFT licensure, but Gina P. was suggesting to us recently that MHC may be more pragmatic. My participation may also be said to help the MAC program meet its objectives, as I contribute a lot of life experience to my class discussions and have assisted project cohorts with expository writing.
As the MAC Admission Requirements note, “in our profession we deal with the reality that some highly trained practitioners are nevertheless ineffective, or worse, harmful as therapists”—serving to remind me that some of my tools may be needed by cohorts along with coworkers. We each have figured out a piece of the puzzle that someone else would benefit from knowing.

To practice spiritual discipline is to believe in the future 
(Nakken, 2000, p. 51).

I feel fortunate to have entered the Master’s program at SMU in particular because of the expressed emphasis on self-awareness and self-care. In my younger years I built a foundation of musical technique through which I will always seek to express myself artistically. Rather than continue to seek the recognition for it in the way I have in the past, I see my music as the primary component in my self-care as a counselor. Relegating my master’s degree training to avocational status is both humbling and liberating. (Though I do confess to having a plan for videotaping my latest compositions to serve as an entry point to a few appropriate concert venues). Even the guitar lessons I teach on weekends—albeit necessary to supplement my meager CDPT income—contribute to self-care, by engendering the sense of familiar competence that comes through utilization of my music pedagogy skills (and by not requiring paperwork!). The MAC program’s emphasis on self-care also further justifies my daily yoga and thrice-weekly swimming routines.
God has placed me in the right place at the right time and, so far as I can tell, made His will known. It is only left to me to strip away those last vestiges of my ego that hold me back, to get out of my own way, and believe in the future.


Nakken, Craig (2000), Reclaim Your Family from Addiction: How Couples and Families Recover Love and Meaning. Center City, MN: Hazelden.

04 December 2014

Narcotics Anonymous Impressions

Narcotics Anonymous plays an essential role in maintaining abstinence for many drug addicts. While this author has attended 12-step programs for more than a decade and has worked as a counselor for addicts for the past year, he had never before attended an NA meeting. While based on the same principles as the Alcoholics Anonymous and Al-Anon meetings familiar to the author, NA is spoken of in the addict community as having a distinct culture of its own. In reading the NA literature, one can find the roots and reflections of this culture, and in attending NA meetings one may experience it firsthand. Through going to NA meetings, the author sought a deeper understanding of the lives of his own clients and to visualize forms their recovery might take.

Into the Fire
It would not have been possible to enter my first Narcotics Anonymous meeting unnoticed. The moment I walked through the door I was hugged by two men in succession. It may have been said that my observer status was further compromised, once the meeting got underway, by at least four members directing their “share” specifically at me. “I know how hard it can be to be here the first time when you feel like you don’t fit in. But trust me, if you keep coming back. . . etc.” As tempted as I was to explain that I am neither chemically dependent nor new to 12-step work, their assumptions placed me in a unique, albeit central, position to observe the attention given the newcomer. As the meeting broke up, I was recipient of additional hugs and encouragement from both men and women, none of whom felt obligated to know any particulars about me before bestowing their embrace. While hugging does not pose an issue for me, I would want to forewarn those with boundary issues to prepare themselves for physical contact at their first meeting. As maintaining sobriety has been found to depend on reaching out to the newly sober (Narcotics Anonymous Fellowship, 2008), it seemed that the best way for me to support abstinence of meeting attendees was to silently maintain the role in which I had been cast.

Getting Physical
The N.A. literature suggests why hugging is more of a component than this author has experienced in other 12-step based meetings (such as A.A. or Al-Anon). “Recovery becomes a contact process; we lose the fear of touching and of being touched. We learn that a simple, loving hug can make all the difference in the world when we feel alone. We experience real love and real friendship.” (NAF, 2008, Kindle location 1614). “We hug all the newcomers who are courageous enough to say, ‘I have three days today.’ We hug you if you have two days clean or two years clean.” (ibid, Kindle location 2951). Offering greeting hugs is commonly assigned as “service work” (ibid).

The Narcotics Anonymous Fellowship was begun in 1953, inspired by the Alcoholics Anonymous program—which itself originated in the late 1930s. AA was the byproduct of one man’s tireless search for long-term sobriety, Bill Wilson. Wilson came to realize that addicts, through the sharing of stories, could be effective in supporting one another’s sobriety—a goal which had eluded the medical field. Drug addicts who were drawn to AA eventually came to desire a program more clearly targeted to them. “Alcoholism is too limited a term for us; our problem is not a specific substance, it is a disease called addiction.” (NAF, 2008, Kindle location 312). The NAF adopted the AA Twelve Steps, making only slight changes in substituting the word ‘addiction’ for ‘alcohol’ and ‘addicts’ for ‘alcoholics.’ That these “principles that made our recovery possible” (NAF, Kindle location 523) are still adhered to is a testament to the power of Wilson’s original concepts. 
In comparing the Basic Texts of both fellowships, however, one finds significant differences in style. The core chapters of Alcoholics Anonymous are imprinted with the literary style of Wilson, which includes metaphors, 1930s colloquialisms, and non-inclusive male pronouns. The NA text—originating in the 1960s—does not convey the personality of any one author to the same degree, and may be considered more accessible and direct. The two texts serve to complement one another. 
The particular NA meeting attended by this author has been going for decades in the Hilltop area of Tacoma. At one time, it was explained to me afterwards, the meeting was exclusively for African-Americans. But in recent years a decision was made to open it up to all ethnicities. It then also became open for non-addicts to attend, as are the many 12-step meetings designated as “open.” 
Members frequently commented on how addiction unites us. An older African-American man gestured to the woman sitting next to him saying, “It’s hard to believe that a young white girl’s story could be so close to mine, but I could have just moved my lips and let her speak it for me!” Another man spoke powerfully about the fear he had to face in recovery. The woman who next spoke appreciated his “share” as “just what I needed to hear today.” In that first meeting, I counted sixteen of us in attendance.

Narcotics Anonymous has in common with other 12-step programs—Alcoholics Anonymous being the best known—a format that opens by reading a standard preamble, followed by the twelve steps and traditions, then perhaps a daily reader entry, leaving the bulk of the meeting for open sharing—frequently on an agreed-upon topic. A universally observed guideline is that there be no “cross-talk”, that is, anyone who shares is given the floor without interruption or direct comment. Those who choose to share will often refer to what they identified with in the sharing of another, but not until after that person’s turn has ended and the new sharer’s has begun. Issues, therefore, are not discussed so much as reflected on individualistically. This practice helps to maintain equality between those tending toward introversion with those tending toward extroversion.
For my second visit, I was permitted to recede into the background as I was no longer distinguished as a newcomer. In fact, there was another newcomer, sitting next to me, to don that mantle. He had a month sober—I learned by asking him as the meeting ended. I guessed correctly that he was in outpatient as he was getting an attendance slip signed. This meeting ended up having about 24 in attendance, men being in the majority. Emerging that day was a common theme on how romantic attachments can challenge or put an end to sobriety. It was more than thought presented on a topic; the desperation to survive a powerful disease could be felt at an animal level. One man stated that it was his third meeting in 12 hours, as though his addiction would route him out if he remained alone for any stretch of time. I had the sense of this roomful of people working together stacking sandbags to stem a flood that would overwhelm anyone of them working on his/her own.

Twelve Steps
Addicts successfully abstaining from drugs are described as being “in recovery.” “Recovery is what happens in our meetings. Our lives are at stake.” (NAF, 2008, Kindle location 508). Most addicts who have managed a significant period of sobriety say that their recovery came through “working the steps.” “By working the steps, we come to accept a Higher Power’s will. Acceptance leads to recovery.” (ibid, Kindle location 522)
The Twelve Steps were designed to be “worked” in sequence with the guidance of a sponsoring individual. “Working” steps 1-8 would take the form of journaling and conversing with one’s sponsor. Step Nine involves making amends to those “we had harmed” and Step Twelve involves “carrying this message to addicts.” (ibid, Kindle location 546). This last is rooted in one of Wilson’s most significant findings. During the period he first experimented with reaching out to other alcoholics, bringing them home for his tutelage, he was unsuccessful in leading any of them to sobriety. Yet he, himself, was remaining sober. It was then he came to realize what he had that the other alcoholics lacked, and understood that they would not be able to stay sober until they too became active in reaching out to help other drunks (Alcoholics Anonymous, 2001).

The Research
Linkenbach (1993) describes an Adlerian take on the Twelve Steps known as “The Bi-directional Addictions Model” in which a therapy client is shown that she/he has chosen behaviors the exact opposite of those outlined in each step. Step Four, for example, originally reads, “Made a searching and fearless moral inventory of ourselves.” The therapist encourages the client take ownership of what she/he has actually been doing: “We avoided through fear, honestly looking at ourselves.” Each of these opposing steps constitute “The Addictions Blueprint” (Linkenbach, 1993).
However effective NA members feel their program is, there are those who are opposed to joining it for a number of reasons. One wonders as to their chances of remaining abstinent. A five-year study of addicts attending versus not attending 12-step meetings concluded that, “Frequent attenders at NA/AA meetings were more likely to be abstinent from opiates and alcohol compared to both non-attenders and to infrequent attenders” (Gossop, M., Stewart, D., Marsden, J., 2007). A sobering further finding was that “less than weekly NA/AA attendance appears to be no more effective than non-attendance” (Gossop, M., et al, 2007). While Gossop, et al did not find statistically significant effectiveness of NA/AA for stimulant users, Donovan and Wells (2007) did. “Increased 12-Step meeting attendance and/or involvement appear to lead to a decrease in subsequent substance use among stimulant abusers.” Their findings therefore, “have prompted clinical researchers to recommend that treatment programs emphasize the importance of self-help groups and encourage 12-Step meeting attendance and participation” (Donovan, D. M., Wells, E. A., 2007). Davey-Rothwell, et al (2008) performed a study of how 12-step involvement can be spread through social networks (in the sense of ‘those one hangs out with’), concluding, “These interactions not only serve as a motivation to decrease drug use through increased social support, but are also an opportunity to exchange resources regarding treatment options” (Davey-Rothwell, M. A., Kuramoto, S. J., Latkin, C.A., 2008)
In a qualitative study of Appalachian women in recovery, Grant (2007) identified three stages of recovery: the disgusted self, the aware self, the alternative self, and the stable self (Grant, J., 2007). Drawing conclusions in reflecting back on one’s recovery process would be essentially what Wilson did when distilling the Twelve Steps. It was in the “alternative self” phase that women in the study availed themselves of the 12-step program. “As many participants stated, help within memberships at A.A. and/or N.A. was giving them proper tools to assimilate themselves into a new social world that included new associations, new and necessary structure, support, knowledge about addiction and recovery, love, the opportunity to relinquish old ways of thinking, and a commitment to something besides alcohol and/or drugs” (Grant, J., 2007).

Living in active addiction is to live without meaning. All humans share an innate desire for meaning in life. Recovery from addiction requires resuming the search for meaning postponed while in addiction. It was found by this author that to attend Narcotics Anonymous meetings is to witness a compelling search for meaning, made imperative by the jaws of relapse ever nipping at the addict’s heels. The testimony shared in these meetings ideally fills one with a profound sense of what it means to be fully human and alive. It is hard to imagine anyone living in this material world who could not benefit from that. 

Davey-Rothwell, M. A., Kuramoto, S. J., Latkin, C.A. (2008). Social networks, norms, and 12-step group participation. The American Journal of Drug and Alcohol Abuse, 34, pp 185-193.
Donovan, D. M., Wells, E. A. (2007). ‘Tweaking 12-step: the potential role of 12-Step self-help group involvement in methamphetamine recovery. Addiction. 102 (Suppl. 1), pp 121-129. 
Gossop, M., Stewart, D., Marsden, J. (2007). Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up study. Addiction. 103, pp 119-125.
Grant, J. (2007). Rural women’s stories of recovery from addiction. Addiction Research and Theory. 15 (5), pp 521-541.
Linkenbach, J. (1993). A bi-directional addictions model. Individual Psychology. 49 (2), pp 248-256.
Narcotics Anonymous Fellowship (2008). Narcotics Anonymous, Sixth Edition. (Also known as The Basic Text). Van Nuys, CA: Narcotics Anonymous World Services.
Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.

01 December 2014

Personal Theory of Counseling

As an educator, I always believed that we best learn what we can connect to something previously learned—the "hook" onto which new information or a new skill may be hung. It may be said that I began my education as a counselor when first a psychotherapy client, at the age of 25. There must have been fewer therapy theories and practices around back then. My therapist, a woman not many years older than I, led me towards an understanding of transference—of needs, of expectations—from family of origin to present relationships. These lessons proved of great value, biasing me towards therapeutic practices that account for the influence of childhood on our present lives. 

Five years later I was introduced to Re-evaluation Counseling, through classes, workshops and support groups. RC prioritized "discharging" the effects of early hurts, in a format where "counselor" and "client" exchange roles. Here I learned that distresses will persist to plague those who do not fully discharge them, and also picked up valuable information on the nature of oppression. The tools and insights of RC will likely continue to form the basis of my therapeutic practice—the sculptor's stone that seeks chiseled refinement. 

Next came exploration of new age modalities, and faith-based practices, that deepened my spirituality and my experience of meditation (having first learned meditation during my undergraduate years through Kundalini Yoga classes). This background puts me at home with mindfulness-based therapy and with leading guided meditation and yoga.

Another important component in my personal theory of counseling came through involvement in the Twelve-step program. The "keeping attention off distress,” done in RC, aligned neatly with certain principles of recovery in Al-Anon. An essential component of both Twelve-step and RC programs is the experience offered in being a counselor as well as a client. In twelve-step this manifests in becoming a sponsor, sharing in meetings, and doing service work. It has been shown that addicts/codependents are frequently unable to maintain their chemical/emotional sobriety without taking responsibility for another’s recovery. In RC, one takes the counselor role for half of each session, and may also develop into a leader of support groups, classes or workshops. While I understand it is not appropriate in the counseling profession for clients to switch roles with their therapist, as a therapist I will direct my clients towards activities that put them in a counselor’s position—empowering and humbling them in ways that only focusing on others can.

In the Human Services program at TCC I benefitted from training in Motivational Interviewing, gaining a new understanding how a counselor cannot take a client any deeper than the latter is willing to go. As this approach is frequently referenced, even mandated, in the addiction counseling field, I have endeavored to assimilate it—challenging RC habits that could be too invasive in some situations.

Thus, I came into the MAC program with many preconceptions on how to counsel others. Here at St. Martin's University, I have been exposed to additional approaches calling out to be integrated into both my current practice with addicts as well as a potential Marriage/Family practice in the future. All of the chapters studied offer useful insights. Most astounding to this reader are the many contributions to the field from Alfred Adler—who comes across as being ahead of his time not simply for his flexibility and ingenuity but for his pervading common sense. A therapist would do as well to periodically review Adler’s discoveries as a composer would to review Stravinsky’s equally ground-breaking Rite of Spring.

Two procedures I wish to learn enough about to incorporate into my practice would be administration of “instruments” intended to measure client progress, from first to last interview, and dream interpretation. Yalom’s facility with the latter is inspiring. I also have benefited from viewing clients through the Stages of Change framework—such as is commonly done in chemical dependency treatment—allowing the therapist to temper his or her expectations to what may be appropriate for a client at that given stage. 

Several of the theories we have studied convince me what I had begun to suspect, that establishing rapport at beginning stages will prove more effective than requiring a client to speak about feelings who is not predisposed to do so. I have long endeavored to be able to speak to anyone about anything. Sometimes a client may only be able to discuss framing houses, for example; so the counselor engages him at that level until a break in the armor may be discerned. This is, in practice, a cultural issue. Awareness and articulation of a feeling may be yet to permeate the male or working class culture of this client—or perhaps it has, but in a way that a female or middle class therapist might not readily recognize. The therapist certainly does not want to be confused with—or be projected onto—previous well-meaning helpers who the client has learned to push away.

I still have not determined how my background as a musician and music educator will figure into my counseling practice. Certainly teaching experience has provided me skills working effectively with groups. But as music is what I do for self-care and to satisfy my muse, it may be best to reserve it for my non-therapist life—particularly considering the perfectionism that comes into play when I make music.