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THEY ARE NOT AT FAULT

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					THEY ARE NOT AT FAULT

         Men’s Issues in Treatment


        Mark Greenberg, M.A.
               Executive Director
Michael’s House The Treatment Center For Men
            Palm Springs, California
  GOALS AND OBJECTIVES
Identify the special needs of male patients in
treatment for addiction.
Identify the main arguments in the
controversy regarding the use of medications
in the context of abstinence-based treatment.
Describe societies messages to the
contemporary male.
Describe ten characteristics of men in the
recovery process.
Rarely have we seen a person fail who has thoroughly
followed our path. Those who do not recover are people
who cannot or will not completely give themselves to this
simple program, usually men and women who are
constitutionally incapable of being honest with themselves.
There are such unfortunates. THEY ARE NOT AT
FAULT; they seem to have been born that way. They are
naturally incapable of grasping and developing a manner of
living which demands rigorous honesty. Their chances are
less than average. There are those, too, who suffer from
grave emotional and mental disorders, but many of them do
recover if they have the capacity to be honest.
                            Alcoholics Anonymous,
                            Pg. 58
      NONVIOLENCE
“To be deeply committed to
negotiations, to be opposed to a
particular war or military action, is not
only considered unpatriotic, it also casts
serious doubt on one’s manhood”
  Myrian Miedzian “Boys will be Boys”
        TELEVISION
What behaviors young men consider
appropriate comes, in part, from the
lessons they learn from television and
the movies.
    E.g., Huesmann and Miller, 1994
        TELEVISION
“American Kids spend 24 hours a week
watching 26,000 murders on television
by the time they reach 18, maybe the
most important statistic of modern life.”
“By reflecting and magnifying our worst
aspects (television) significantly
aggravates these tendencies, especially
in children, whose values and attitudes
are in the process of being formed.”
    Myriam Miedzian, “Boys Will Be Boys: Breaking
    the link between Masculinity and Violence”
            MOVIES
The amount of violence, sex, and
profanity in today’s average PG-13
rated movie approaches that of an R
rated movie in 1992.

  Parents Television Council, 2002
VIOLENT VIDEO GAMES
Academic achievement was negatively related
to overall amount of time spent playing video
games.
Exposure to a graphically violent video game
increased aggressive thoughts and behavior.
Exposure to violent video games will increase
aggressive behavior in both the short and
long term.
    Craig Anderson, Department of Psychology, University of
    Missouri
    Karen Dill, Department of Psychology, Lenoir-Rhyne
    College
COLUMBINE HIGH SCHOOL
 Harris and Klebold launched assault
 murdering 13 and wounding 23 before
 turning guns on themselves.
 Harris and Klebold enjoyed playing the
 bloody, shoot-’em-up video game
 Doom, a game licensed by the U.S.
 military to train soldiers to effectively
 kill.
     HIDDEN SELF
SUPERIOR ATTITUDE
SELF SUFFICIENT
SUPERIOR ATTITUDES
INTELLECT
SEXUAL SUCCESS
MONEY
PRESTIGE
ISOLATION
DEPRESSION
ANGER/RAGE
COMPARISONS
“At the age of twelve, A boy
starts imitating a man, and
he just goes on doing that
for the rest of his life.”
 Mark Twain
ADMISSION
MAINTAINING
 CONTROL
   PROFANITY
“THE ABSENCE OF PROFANITY WILL
OFFEND NO ONE.”
 From the Desk of Bill W.
    SELF-
CENTEREDNESS
“Selfishness-self-centeredness! That,
we think, is the root of our troubles.”
“Above anything, we alcoholics must be
rid of this selfishness. We must, or it
kills us!”
  Alcoholics Anonymous pg. 62
ACQUIRED SITUATIONAL
     NARCISSIST
DEVELOP
 Arrogance
 Invulnerability
 Entitlement
Terminal Uniqueness must be overcome
SHAME
GRIEF
       FEAR
“This short word somehow
touches about every aspect
       of our lives.”
 Alcoholics Anonymous pg.
             67
 SEXUAL IMAGE
“We all have sex problems.We’d
 hardly be human if we didn’t.
 What can we do about them?”
     Alcoholics Anonymous pg. 69
 PURSUIT OF BRYANT
OVERLOOKS RAPE CASE
6/29/04
 “This week Kobe Bryant becomes a free
 agent. NBA superstar Kobe Bryant. And
 all through the NBA owners and general
 managers and coaches are staying up all
 night trying to figure out how to sign him.
 They don’t care that he’s a rape suspect.
 They don’t even pretend to care.”
   Michael Rosenberg, Detroit Free Press
TREATMENT OF ADDICTION
  AND MENTAL HEALTH
      DISORDERS
 “Bodily and Mentally different from his
 fellows.”
   Alcoholics Anonymous pg. 30
 “There are those too, who suffer from
 grave emotional and mental disorders,
 but many of them do recover if they
 have the capacity to be honest.”
   Alcoholics Anonymous pg. 58
 MENTAL HEALTH AND
    ADDICTION
ECA Study (1990)
 45% of those with alcohol disorder, 72%
 of those with drug disorder had at least
 one other psychiatric disorder.
 78% of alcoholic men met lifetime criteria
 for another psychiatric disorder.
    DUAL DIAGNOSIS
Journal of the American Medical
Association suggests:
  37% of alcohol abusers
  53% of drug abusers
    Also have at least one serious mental illness
     DUAL DIAGNOSIS
Psychiatric Disorder Increased Risk for
Substance Abuse Disorder
  Antisocial personality disorder         15.5%
  Manic episode                           14.5%
  Schizophrenia                           10.1%
  Panic Disorder                          4.3%
  Major Depressive Episode                 4.1%
  Obsessive-compulsive disorder            3.4%
  Phobias                                  2.4%
     National Mental Health Association
ADDICTION AND ATTENTION
    DEFICIT DISORDER
  23% of patients (adolescents and adults)
  with substance use disorders have ADHD.
  Treatment of children with ADHD with
  stimulants has a “protective effect” with
  regard to development of substance use
  disorders.
  ADHD not treated in childhood, occurrence of
  substance use disorders have a 2-3 times
  increase over the rest of the population.
  ADHD treated in childhood have ½ the risk of
  developing substance use disorders than the
  rest of the population.
       Wilens et al Pediatrics 2003
TREATMENT OF ADDICTION AND
 MENTAL HEALTH DISORDERS
 Non medication treatments of anxiety,
 depression and ADHD
   Psychotherapy-group and/or individual
   12 Step Support Groups-AA,NA,CA, etc.
   Wait 3 to 4 weeks into treatment to give
   medication unless:
     Obvious history of Mental Health Disorder preceding
     substance use or during abstinence periods of at least
     one month duration
     Or symptoms so severe safety is a concern
       – I.e. psychosis from methamphetamine
   NON MEDICATION
     TREATMENT
Gives them a chance to a sober life to
develop some form of spiritual guidance
“It works-it really does”
  Alcoholics Anonymous, “Into Acton” page
  88
       TIME,TIME TIME
Benefits of Long Term/Extended
         Care Programs
1. Peer support
2. Provides a surrogate family type of support
   that extends the treatment process into the
   full 24 hour period each day.
3. Family of origin issues.
4. Increased time of clearing.
5. Treatment team has more time to evaluate
   patients after they clear.
6. Removal from a relapse environment provides
   the energy needed to recover.
       THE BIG BOOK
Page 45, “Well, that’s exactly what this book
is about. Its main object is to enable you to
find a Power greater than yourself which will
solve your problem.”
Page 77, “Our real purpose is to fit ourselves
to be of maximum service to God and the
people about us.”
Page 98, “Burn the idea into the
consciousness of every man that he can get
well regardless of anyone. The only condition
is that he trust in God and clean house.”
Trust in God, Clean house, and help others
   SPIRTUALITY AND
      ADDICTION
79% of Americans believe spiritual faith
can help people recover from disease
63% of Americans think physicians
should talk to patients about spiritual
faith
   SPIRITUALITY AND
ADDICTION, THE TWELEVE
         STEPS
 Provide a framework for personal
 change through spiritual principles
 Provide hope for the hopeless
 Can be used for more than just
 addiction
 A good tool for living life
SPIRITUAL AWAKENING
“WE MAY HAVE HAD CERTAIN SPIRITUAL
BELIEFS, BUT NOW WE BEGIN TO HAVE A
SPIRTUAL EXPERIENCE.”
“WE HAVE ENTERED THE WORLD OF THE
SPIRIT. OUR NEXT FUNCTION IS TO GROW
IN UNDERSTANDING AND EFFECTIVENESS.
THIS IS NOT AN OVERNIGHT MATTER. IT
SHOULD CONTINUE FOR A LIFETIME.”
  Alcoholics Anonymous, “Into Action”

				
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posted:11/27/2011
language:English
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