In this episode, we examine the most shameful of all addictions, sexual addiction. We will define addiction, identify how addiction impacts family members, and the addicted person. A case example is presented to highlight these issues
Did you ever go looking for something and can’t find it? Of course you have!
How about in the process of looking for that other thing,you found something else? Of course you have!(And didn’t find the main thing I was looking for)
This is what I found:
if you unaware of who Lois Wilson is read this:
change is possible
This shows describes the deadliness of fentanyl, a highly potent opioid which is killing off the population of young adults at an alarming rate. With all the information on the “heroin epidemic”, there is little information about this deadly and apparently very available drug.
1990’s WWE wrestler Brian James shares poignantly about his addiction, his 5 trips to rehab and his sobriety
change is possible
Dedicated to LC who didn’t live very long but inspired many
Many years ago Linda was a client that I was working with. She was a very complicated young woman. She had chemical addictions, eating disorders and an assortment of other significant issues. Her chemical addictions were getting out of hand and she needed to go to detox. Linda agreed and assured me that she would go on Monday. On Monday, after she didn’t arrive at the detox, I called her and the conversation went something like this:
Me: What happened?
L : You know
Me: You took a detour?
Me: Ok, (pause, pause, pause,)but really you need to go to detox
L: I know
Me: How about tomorrow
Me: So you’ll call them now so you can get in tomorrow?
Me: So you are going tomorrow?
Me No detours?
L: No detours
Linda did arrive at detox the next day, she looked like, someone who was on the highway to hell. She completed detox, but soon her multiple issues and continued detours led her to her final highway. She died way too young, unable to deal with many issues that she could not even speak about.
Linda’s detours sadly led to her undoing in a permanent way, but many people that I see don’t listen to their internal gps settings. They appear to be on the verge of getting better only to get off of “Healthy Road” and make several turns on to “Self-Defeating Avenue” or “Self-Destructive Boulevard”. These detours tend to last way longer than necessary and ultimately lead to lots of guilt, shame, remorse, and self-loathing. When people drive back and find “Healthy Road” they generally have to clean up the messes they made from their detour. As people start to clean up those messes they begin to ask themselves the following questions:
• Why did I do that?
• What’s wrong with me?
• Why can’t I succeed?
• Am I doomed to always do this?
• Can I be healthier?
When people bring these questions to my office, we need to do some probing for the answers. We need to look at how their detouring behavior is “wired”— that is what causes this behavior? Is it something from their past? Is it a long standing issue with their self –esteem? Is it from some traumatic event that has occurred? There may be hundreds of hypotheses about the reasons this behavior exists and the mechanisms that keep this behavior going. Once we have an idea about why a person may detour, then we need to identify how to change this. This can be a very painful process because some the issues have never been addressed. It takes great courage, patience, and trust to work through the pain.
Linda never got the opportunity to do this. Her detours to hell, ultimately led to her demise. Her fear and shame led her to take her secrets with her to her death.
As we head for the New Year, we can work to stay on “Healthy Road” with frequent turns towards “Self-Improvement Street” and “Feeling Better About Myself Avenue”. Whatever the issues are, they can be identified, and healed. No one needs to keep detouring from the right path.
Change is possible
From John Oliver “Last week with John Oliver 11/15/2015
“…grant me the serenity to accept the things I cannot change…”
It’s getting close to one of my favorite times of the year–the start of baseball season. In order to get ready for the upcoming season, it’s important to have a historical perspective. As a die hard New York Yankee fan, I am going to commit a blasphemous act–I am going to discuss a legendary Boston Red Sox player. Manny Ramirez was their left fielder for 8 years, and was probably one of the Sox’ most popular player. He had a knack of saying the wrong things at the wrong time, losing track of the game, and generally being on his own planet. Redsox fans described this as Manny being Manny.This video describes many of these Manny being Manny moments:
Wikipedia finishes our Manny Ramirez story:
In 2009 he was suspended 50 games for violating baseball’s drug policy by taking human chorionic gonadotropin (hCG), a women’s fertility drug.According to steroid dealer Victor Conte, hCG is often used to restart natural testosterone production after a steroid cycle.In the spring of 2011, Ramirez was informed by MLB of another violation to its drug policy, which could result in a 100-game suspension. He chose to retire on April 8 rather than face a 100-game suspension.
You would expect nothing different from Manny since he was a person who played by his own rules. Although an exciting and charismatic player, Manny was always being Manny.
In our daily lives, we are unlikely to find a Manny Ramirez. We will however find people who are difficult to deal with. When we encounter these people, we can choose to either get upset or accept them. Let’s look at these three vignettes, and answer the question that follows:
Paul Maxwell is a 60 year old man who happens to be your father. Paul has an interesting character trait. He likes to flirt, and make advances on all of your friends. (These women are in their 20’s) One of them has described his behavioral eloquently as being “PaulMaxwelled”. When Paul Maxwell is your dad you have several choices:
A) Arrange a hit on his life (not a great idea)
B) Kill him yourself(a worse idea)
C) Become terribly depressed, anxious, ashamed, with no self-esteem and feel further victimized by Paul Maxwell
D) Accept that Paul Maxwell is being Paul Maxwell and get therapy for yourself in order to feel better
Jenny Malone is your new boss. Jenny is the company hotshot brought in from another state. She is replacing your best friend who has left the company. As a employee of the company for the past 10 years, you have given them your blood, sweat and tears. Jenny decides to change all the things in the department that have worked for the 10 years that you’ve been there. After massive frustration in dealing with Jenny you decide to:
A) Punch her in the face(not a great idea)
B) March into the Vice-President’s office, shouting expletives, and describing in full detail her late hour escapades with other employees of the company(not a great idea)
C) Leave the best job that you’ve had with the awareness that you will never get a job this good again
D) Accept that Jenny Malone is being Jenny Malone and get therapy for yourself in order to feel better
Vignette Number 3
Bobby and Janey Duncun have been married for 5 years. They have a child, Bobby, Jr who is 6years old. Bobby Sr. drinks every day. Sometimes while drunk, he has gotten angry with Janey and called her choice words . Janey has tried to get Bobby to stop drinking. She’s thrown out the alcohol, yelled and screamed at him for drinking, negotiated deals with him so that he wouldn’t drink. She is angry and frustrated and feels unloved. At this point Janey’s best strategy is to:
a) Continue to nag, scold, beg, cajole, scream in order to get him to stop drinking
b) Have an affair with very interested neighbor Billy Washington down the street
c) Take little Bobby and move back home with her alcoholic parents
d) Accept that Bobby is being Bobby(while getting therapy and attending Alanon)
The obvious answers to our quiz is “D” in all of these situations. The thing we learn from all of this is that Manny Ramirez, Paul Maxwell, Jenny Malone and Bobby Duncun are starring as themselves– They do what they do in ALL situations. Manny is just being Manny, Paul is just being Paul, Jenny is just being Jenny, and Bobby is being Bobby.
When we encounter these people our best option is to ACCEPT them and their behavior. In order to do that we need something that will help us–the serenity prayer:
If we ACCEPT what we cannot change, which are all other people’s behavior, and change the things we can, which is our reactions to them, then we can have serenity. 3 sentences can give us all the change we need. Use them regularly and you will feel better.
Remember change is possible.
The daughter of the mayor-elect in New York has had alcohol/drug/depression issues and had come forward to help others. Very useful, very powerful, very hopeful message.
ESPN football analyst and former NFL player Robert Smith shares his story on alcoholism.
He is very candid and talks about the need to admit you have a problem and do whatever it takes to get sober.
This blog is a special one. I am lucky to have a guest blogger who is a friend of mine for over 20 years and an expert in the treatment of compulsive gamblers. NJ recently passed a law legalizing on line gambling. In addition, one of the major changes in the new DSM V relates to compulsive gambling. It has gone from an “Impulse disorder” into a diagnosable addiction similar to alcohol or drug addiction. To explain all of this in more detail, is Lenny Brazer
Most research suggests that when the public has access to the availability of gambling the number of people who gamble will increase. This is not rocket science. The concern of professionals who treat problem and pathological gamblers is that with the increase in the number of people who gamble the proportion of those who will encounter problems or become pathological gamblers also will increase as well. Once again in New Jersey there is going to be a significant increase the amount of gambling that takes place. Gov. Christie recently signed legislation that will legalize online gambling. What this means is that virtually any person who has a computer or access to the Internet will be able to gamble in the comforts of their home. This will include gambling machines table games and any other type of gambling that goes on in the casino.
There are many caveats as well as benefits that go along with this new legislation. On the positive side the legislation will enact for the first time a significant source of funding for the treatment of problem/pathological in the state of New Jersey. Casinos in order to be licensed will have to pay an annual fee of $150,000 and it is anticipated that eight casinos will apply for the license. Portions of that money will be divided between treatment and prevention/education via the Council on compulsive gambling of New Jersey Incorporated. One anticipated difficulty in spite of some sophisticated language and controls will be monitoring whether underage (people 18 years of age and younger)will be able to access a site and gamble illegally.
The American Medical Association recently published its Fifth edition of the Diagnostic and Statistical Manual of mental disorders(DSM V). An important departure from previous diagnostic manuals is that the substance related disorders chapter has been expanded to include Gambling Disorder this change reflects the increasing and consistent evidence that some behaviors such as gambling activate the brain’s reward system with similar effects to those of drugs of abuse and the fact that gambling disorder symptoms resemble substance use disorders to a certain extent.
In order to diagnose gambling disorder one must have a persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress as indicated by the individual exhibiting four or more of the following in a 12 month period.
1) Needs to gamble with increasing amounts of money in order to achieve the desired excitement
2) Is restless or bored when attempting to cut down or stop gambling
3) Has made repeated unsuccessful efforts to control cutback or stop gambling
4) Is often preoccupied with gambling e.g. having persistent thoughts of re-living past gambling experiences, handicapping or planning the next gambling venture, thinking of ways to get money with which to gamble.
5) Often gambles when feeling distressed e.g. helpless guilty anxious depressed.
6) After losing money gambling, often returns another day to get even “chasing” one’s losses.
7) Lies to conceal the extent of one’s involvement with gambling.
8) Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
9) Relies on others to provide money to relieve desperate financial situations caused by gambling (bailout).
Gambling behavior is not explained by a manic episode.
When making the diagnosis one can differentiate between
Episodic:meeting diagnostic criterion at more than the one time point with symptoms subsiding between episodes of gambling disorder for at least several months.
Persistent: experiencing continuous symptoms to meet diagnostic criteria for multiple years.
It can also be classified as in Early Remission:
after full criterion for gambling disorder were previously met none of the criteria for gambling disorder have been met for at least three months but for less than 12 months.
Sustained Remission would suggest that after full criterion for gambling disorder were previously met none of the criteria for gambling disorder have been met during a period of 12 months or longer.
Severity can also be monitored now, ie mild 4 to 5 criteria met; moderate 6 to 7 criteria met; severe 8 to 9 criteria met.
Discussions during the development of these new criteria suggested that the reclassification of pathological gambling from being an impulse control disorder to a behavioral addiction will help those who have been suffering from this disorder gain access to treatment. It was also suggested that more insurers would recognize gambling disorders as treatable and third party reimbursement for treatment would increase. That is yet to be seen. Given the potential proliferation of gambling that will be happening in New Jersey, this therapist certainly hopes for the aforementioned to become realities.
Leonard Brazer Ed.S. CCGC
300 West Main Street
Rockaway,New Jersey 07866
Leonard Brazer, Ed.S., M.A., CCGC is a New Jersey Licensed Marriage and Family Therapist. He is also a certified New Jersey School Psychologist and a Certified Compulsive Gambling Counselor. He completed a one year internship in Clinical Psychology at Monmouth Medical Center. His professional degrees are from Seton Hall University. Mr. Brazer worked for two years in a Mental Health Center prior o entering the field of addictions in 1980. He has developed comprehensive Chemical Dependency Rehabilitation Programs for adults and adolescents. Mr. Brazer also founded and supervised the Pathological Gambling and Money Disorder Programs at Saint Clare’s Hospital, and at Hackettstown Hospital.
Mr. Brazer has appeared as a guest on the Sally Jessie Raphael, Joan Rivers, Good Day New York, News Talk New York, Channel 12 News, The O’Reilly Report and Caveat Venditor, and on various radio talk shows as an expert, offering information on gambling and money disorders. He has written articles for several major New Jersey newspapers, and authored a chapter for a text “I Shop, Therefore I Am, Compulsive Buying and the Search for Self”. He has consulted with 48 Hours and the Oprah Winfrey shows on feature stories regarding gambling and spending. As well, he has lectured at most major statewide conferences and East Stroudsburg University, Montclair State University, and New Jersey City University.
Mr. Brazer has been a private practitioner and consultant since 1983.