How About that:

Yesterday was my 78th Birthday. Yup!  All day long! I must admit that I really do not relate to the number 78. I know that I am a very fortunate person. I have a wonderful husband four equally great children and eleven grandchildren; everyone is healthy and caring, loving life in all its diversity, challenges, joys and disappointments. I am asking myself, why am I writing all this? Certainly the big wide world of the internet isn’t interested in that little bit of insignificant information. Well, when I sat down to write my newsletter I reflected on a message and thought that perhaps to simply write spontaneously what’s on my mind at the moment might be the best way. So here it is.

As I reflect on my life, which I usually do on my birthday, I realize more every year how extraordinary my first 20 years of life were. I was born at a time of history when horrendous atrocities were committed by some incomprehensibly evil person/s. As a result, ordinary people like me and my family died or were traumatized and tormented for years in other ways. Yet, here I am, in America, sitting at my desk in the office of our beautiful home, feeling enriched in so many ways, in spite or because of my dark past. I don’t know how I would be today without the horrors I experienced – but I do know one fact for certain – that life is a miracle and the good Lord gave us the gift of choice –sometimes a curse, but eventually, I learned that it is a blessing that equals nothing else in life. Did I suffer? Of course – then and for 10 years after I was twenty I was deeply depressed because I could not adjust to the American way of life – it was too jarring coming from where I was. Today it would be called Post Traumatic Stress Syndrome which is obviously survivable.

What’s the benefit?

As I am writing the above, many thoughts and feelings emerged which thematically lead nicely into what I thought of writing about. I guess after reading the above, the connection might make sense to you. Most of you know that I have worked in the field of addiction for many years (as in many other areas of mental health), and I am often asked what prompted me to adapt such diverse views on addiction treatment in my practice, popular writings and trainings from what has been considered the norm, namely AA and the disease concept. The answer is relatively simple; my clients taught me. I listened with an experienced heart, not addiction, but life; I believe from my own experience in the resilience of the human spirit and instinctual desire to live. I also know that often life has the tendency to push us into directions that we might later regret – oh, the blessings of a troubled mind – the red light making us pause to reflect and listen to, or try to discover, that which could put our soul at rest; an answer that none other than each of us holds deep within. I guess, in America this is called Freedom and Integrity. There are many ways which lead to the answer – as Robert Frost encourages “travel the Road less taken” and Robert Kegan writes we “are in the throes of our own becoming”. Aren’t these two wonderful quotes? How life affirming and supportive! To realize that our past gave us information about ourselves, how strong we really are and how wise the detours were that now make sense, because we are alive and able to fully comprehend the choices that we are privileged to make because we are not only responsible but response-able.

Yes, there is much to learn. A baby must learn to walk before it can run, the now adult must learn and practice making the word love a verb before one can love another. The life skills that couldn’t be learned in a healthy developmental sequence, moi included, can now be recovered using the supportive, process-oriented Growth Process Affirmation™. They will add to the difficult lessons learned and hold the potential to realize one’s self in many dimensions, share the gifts with others and make this a better world – one little action at a time.

So, you see, nothing in life is wasted – ever. We can recycle ourselves based on our unique strengths and become the creatures God intended us to become and the world needs. It’s called Opportunity.

Some time ago, the State of Providence, RI had a very colorful, dearly loved mayor. Not only was he powerful politically, he also had an amazing talent to keep his followers sitting on the edge of their chairs (or couches) reading the latest stories about his political successes and most of all his colorful personal escapades. There is no greater joy for the citizens of the smallest state in the USA to gain national attention so frequently. Unfortunately, as most good things, the mayor’s reign came to an end after an ugly episode with his wife’s lover – or was it politically fuzzy? Who am I to know? (I don’t think I am being unkind writing this, because I heard this morning that he wrote his memoir to inform everybody in the State just what really happened. And, from the sounds of it, he owns quite a bit). A “must read” for sure. In any case the Mayor had to move from his exquisite home on the East Side to a less desirable location – ugh – even ugly – a penitentiary, for five long years. Oh, reading the newspaper became so boring!

However, don’t be concerned, RI is never dull. The once upon time mayor returned to little Rhody some time ago, albeit minus his famous toupee. He is now an astute and provocative news commentator – and is still reviled by some, revered by many. I do know one thing. If Buddy would run for office again, he’d get in with an overwhelming majority of voters! How about it Buddy?

NOW, what about that?

Good question. What stands out for me as a Gestalt Coach and Therapist is how exquisitely Buddy lived out his polarities. What’s that, you might ask? Well, polarities are part of everything and everyone. Basically, they are opposite characteristics like i.e. inquisitive/dull, caring/judgmental, the Yin and the Yang of existence.  Right now it’s bloody cold here, in the summer unbearably hot and humid. The snow is melting, though still frozen a couple of feet high giving the appearance of death in nature and, yesterday, where the ice melted close to the house, I saw daffodils peeping through the ground. So with Buddy; he is incredibly intelligent and he could be so stupid at times; he has the capacity to make people proud of their State and bring national shame and embarrassment upon them.  He loves and can be dismissive in the cruelest ways – no, he does not have a multiple personality disorder, rather he is living out his polarities and learning about himself and life. There is a poem by e.e.cummings that best describes this process.

a total stranger one black day
knocked living the hell out of me-

who found forgiveness hard because
my (as it happened )self he was

-but now that fiend and I are such
immortal friends the other’s each

People who are multi-dimensional are never boring, mostly curious and alive, where as individuals who are fairly constant and predictable in their moods and behavior, are generally less interesting and one-dimensional.

In my therapy and coaching work with clients I am stimulated by each of these positions. A quiet person’s way of being is often expressed dulled to excitement and lives a same as always, unsatisfying life. We know from much research that without feelings and emotions existence can take on oppressive depression. Undertaking birthing one’s own polarities brings immense opportunities for creating a fuller, richer life. For the multi-dimensional individual, growth lies in a different direction. Often polarities express themselves fully in opposition and tend to constrict success so that the process of honoring the good and the bad becomes essential. Why the bad? Because if we are fully aware of that undesirable part of ourselves we can embrace it, use it if and when appropriate rather than trying to deny that undesirable part that will sabotage us no matter how we try to suppress it

Another possibility would be to synthesize both attributes. We can reason between the two what is useful and what is not and thus are able to give a measured response.

That we possess both positive and negative attributes is a given, how we live with them and what we do with them, is a choice. (An aside: while I certainly cannot speak for Buddy, I imagine and I realize that I am making a big assumption, that writing his memoirs has the effect of making peace with his polarities.) The above methodology of recognizing, accepting and/or synthesizing what we love and hate ourselves is enormously meaningful and applicable to all individuals with or without coaching or therapy.

In my work as coach these concepts take on particular meaning when working with recovered/ing individuals in my non-AA, alternative, and holistic Beyond-Recovery process that I am presently teaching for the Institute for Life Coach training and in my Gestalt Institute of Rhode Island.

In closing and as adjunct to cummings poem I want to mention the paradoxical Gestalt Theory of Change that: Change happens when you become who you truly are, not when you try to be what you are not.

How will you know if you are expressing polarities? EASY as pie. One  little word.
But
I’d love to hear from you what you came up with. It really is fun!!!

Be well, curious and surprise yourself every day!

When I began working in the field of addiction 30 years ago, most clients were automatically labeled addicts, (yes, shocking but true) just as most clinicians were either recovered individuals or members of addiction-troubled families. Of course, the field has evolved and what was once held to be gospel truth has been modified and re-labeled. The purpose of this brief paper serves to highlight the confusion and complexities inherent when assigning the label “Addiction”.

Addiction may be:

• Disease/illness; Disorder DSM-IV-TR, (insurance reimbursement)
• Not illness but can create lots of physical illnesses
• Myth of Alcoholism (Herbert Fingarette; scientific data)
• Concept, not illness (Jellinek)
• Spiritual depravity, character defects – AA fellowship only salvation (AA)
• Hedonism – following the pleasure principle – feels good (our limbic system)
• Everyone is addicted (Andrew Weil, Harvard Conference presentation)
• Genetically programmed (unproven, research not universally validated)
• Big multi-billion dollar business
• Treatment and discomfort depends on the healthcare providers’ projection (Ellen Langer, Harvard)
• Resulting from abuse and trauma
• Life-style issues
• Once an addict – always an addict vs. once a human being – always a human being
• Organismic self-regulation, creative adjustment to what is
• My theory is better than yours philosophy !

The above bullet points are not inclusive and perhaps none speak to each reader. My heart goes out to clients and clinicians for both are, one might say forced, to give a diagnosis that pretty much will stay with an individual for life i.e. failed attempts to purchase life or health insurance etc. Are any of our noble attempts really helpful? Statistics vary hugely; it all depends on who provides them – each program is the best on the web.  The questions really become: Can a label alone define anything? Who is the client? What is his/her experience; a good question because some will say addicted individuals can’t think clear enough for recall or have warped perceptions. Others will claim that there is no cure; what does that mean? Why bother? Who is the individual who has learned to overuse substances? Are they embodied in their drinking, drug-using activities?

In conclusion, my professional belief is that what is, is and whatever works, works. I see each individual as a wonderful, complex, highly unique individual who trusts or learns to trust me that s/he is deserving. Kierkegaard wrote that “if you label me you negate me”; a powerful statement that invites all professionals to have an open mind, an open heart, to see and experience the client/professional relationship not as two separate, isolated human beings but in an I/Thou co-created dialogical relationship. This is how we both experience our working together. Believe me, it isn’t always easy. You may see it differently and I would really love to hear your experience and position on the issue of “Addiction.”

You may find more information on my website www.GestaltRI.com; LinkedIn and Facebook.

References:

Alcoholics Anonymous (2001) Alcoholics Anonymous World Services. Fourth edition. Inc. New York City.

Diagnostic and Statistical Manual of Mental Disorders (2000). Fourth edition. American Psychiatric Association.

Fingerette, Herbert (1988) Heavy Drinking. The Myth of Alcoholism as a Disease. University of California press.

Jellinek E.M. (1960). The Disease Concept of Alcoholism. College and University Press. New Haven, Ct.

Langer Ellen J. (1989) Mindfulness. A Merloyd Lawrence Book. Lifelong Books. Da Capo Press.

Vaillant M.D. George E. (2008). Spiritual Evolution. A Scientific Defense of Faith. Broadway Books, New york.

The above is a very limited selection of references that contributed to the shaping of my philosophy. For more information and my own publications, please visit my website www.GestaltRI.com

The holistic and positive aspects of Gestalt therapy makes it ideal for the treatment of any addiction related problem.  It allows for the greatest possible treatment variables in approaching individual differences, stresses the uniqueness of each person, admires the resiliency of the human spirit, and appreciates the integrity and spirituality of any individual.

Gestalt therapy sees the whole as greater than the sum of its parts.  It bridges the gap between cognitive and behavioral therapies by including the body, emotions, senses, and the phenomenological field of the individual as a context for the decision making processes and their behavioral execution.  One of Gestalt’s major premises is that all our coping mechanisms are creative adjustments to the stresses of life depending on the developmental readiness of the individual: Creative, because they are chosen among several alternatives; and adjustments, because they alter the experience in some way.  Gestalt therapy presumes that the individual organism attempts to self-regulate, and all coping mechanisms are considered positive until they no longer serve well their intended purpose.

The Gestalt awareness/experience/contact cycle can be demonstrated as follows:

When healthy individuals are thirsty, they allow the emergence of their need for water to become figural:

through the awareness of sensations (dry throat)

through identification of need (I am thirsty)

to activation of energy (go to the water faucet)

to action (pouring water and drinking it)

to contact (cool water feels good)

to enjoying the process of need satisfaction and withdrawal, leading to organismic homeostasis (no longer thirsty).

When this natural completion of the cycle becomes blocked, dysfunction occurs and the individual becomes stuck in habitual behavior patterns.  Considering the chaotic histories of most substance abusers, a clear figure (need) cannot emerge.  Thus, the awareness-contact-withdrawal cycle is interrupted through misidentification of sensations and inappropriate need fulfillment.  Eventually behaviors become rigid, then they become addictive patters that do not allow self-regulation and homeostasis to occur.

Examining the interruptions

In addiction treatment it is imperative that this cycle and its interruptions be examined in the context of the individuals’ problems, relationships, and environmental field.

The Gestalt 10-Step Program for Addiction and Trauma Recovery organizes the evaluation of the client’s lifestyle in the context of the awareness-experience cycle and the recovery stages from addictions or related problems (See table 1).  They also serve to make individuals co-responsible for their lives, stress decisions and choices, relationships, and the person’s phenomenological world.

The first three steps stress the personal decision/choice processes by examining our contribution to our problems, and work toward an examination of our lifestyle and the re-discovery of our long-abandoned internal and external supports.  Steps four and five allow us to examine our problem development as part of a process in connection with others at a particular time and place.  In addition, it stresses that we should examine our coping skills as strengths that help us to survive.

Steps five and six encourage individuals to look at how they keep unfinished business from the past alive and how it interferes with healthy living.  Relationships become particularly important here as sources of information and strength, because most of our unfinished business is lived out in relationships.

Accepting ourselves

In steps seven and eight, we accept our own and others’ inherent strengths and weaknesses and a healthy interdependency results.  The phenomenological world of individuals becomes enlarged with steps nine and ten, as we fully accept our strengths as weaknesses, pains and joys, as part of the human condition.

Source: Helga M. Matzko, MA, CAGS, CCMHC, ACDP, Gestalt Institute, www.gestaltri.com.

The Addiction Letter: A Resource Exchange for Professionals on Preventing and Treating Alcoholism and Drug Abuse

Vol. 9, No. 11

November 1993

ISSN 8756 405X

Is addiction of any kind a disease or does overusing substances, food etc. cause diseases? Is a disease of addiction a mere concept as Jellinek suggested in the Foreword of his book The Disease Concept of Alcoholism(1960) because he was himself reluctant to call this addiction a disease? Or is it a life style issue as some suggest; a character flaw and the result of spiritual depravation? Certainly there are many such views and more in this hotly debated topic.

Having worked, taught, and written about this thing called addiction for 30 years, I have gained a totally different view. And who taught me? None other than every one of my clients. Kierkegaard wrote that “If you label me you negate me” and labeling, my clients taught me, diminishes their being. Consequently, I no longer see addiction as a disease as it is commonly described, but rather a courageous search for meaning and an ultimate quest toward wholeness.

Here are some of my insights I have gained from my clients:

1. The foundation for addictions was laid in early childhood prior to the actual onset of addictive habits, and in the context of the family and social mores. From the beginning the child and care takers co-created behaviors and relationships.

2. Yet, there existed support and use of internal strengths for the child to live long enough to survive and become sober. Strengths in the life of an addict? Absolutely, yes! Consider, surviving a difficult childhood, using one’s own creativity to modulate and survive experiences while simultaneously evolving into full-blown overuse of substances in an effort to assert a self and attempt to make sense out of a senseless life. Then embracing sobriety,  with or without treatment or self-help programs, they still have stamina and drive to want more, fulfill unmet needs,  and design a life to make unrealized dreams become a reality. That demonstrates strengths of perseverance, resilience, creativity, and hope par exemplar.

3. Contributing factors to the onset of addiction:

In addition to the possibility of genetic vulnerability (at this point unproven, however, possible), most people who develop addictive habits come from an environment that disallows for the natural flowering of a child’s developmental potential. Without detailing all possibilities, many children grew up in dysfunctional families and many have experienced to various degrees trauma, familial mental illness i.e. depression, violence, physical – emotional – mental abuse, or poverty. Minimally, the impact of these toxic experiences on the developing child limited their healthy progressive developmental phases. Similarly, at the opposite extreme, are families who overindulge their children without ever-setting limits and teaching age-appropriate responsibility.

Sounds dismal? At first glance, yes, until individual innate human strengths and creativity in action is stressed, surface, and evidenced when making changes.

4. Creative use of options: barrowing from Gestalt Therapy, a creative adjustments is what one does and how one responds to situations and people. It is a creative response, because one chooses from among the possible options available developmentally and in doing so changes the situation in some way and makes it personally manageable. For example, a child may be sensitive and cry easily, rather than being reassured, she is yelled at and told that if ‘you don’t stop immediately, I’ll give you something to cry about’. That little one may hold its breath, not cry, withdraw or start smiling when hurt. Another may be curious, energetic, and enjoy exploring –and – may break a new toy someone just gave him. He is yelled at for being bad and hit, told that he is a terror and hopeless. That little kid may learn to fight back throwing temper tantrums, hit and kick or begin acting and feeling exactly what he internalized and become a loser.

Most of us have memories of some experiences of ‘injustices’ during our childhood. Luckily, human beings from infancy on are wired and capable of experiencing a lot before we actually internalize a distorted self-image. Yet, when these insults are heaped upon the child incessantly, the once adaptive and age-appropriate modulations become automatic and eventually deeply anchored in the child’s reality, behavioral repertoire, and belief system.

When a larger social system like school requires an expanded repertoire of behaving and responding, the children we are describing lack the experience of flexibility and response-ability other youngsters may have or easily learn. Most likely, the school age child will simply intensify what already exists and ironically recreate experiences that are familiar from at home and ironically reinforce what s/he already know and believes about the world and themselves in it.

Adolescence, while difficult for most teenagers regardless of mental health, paradoxically holds the potential for bringing some relief to the troubled kids because they find a cohort of similar kids – lost, distraught, violent, and depressed. Together, they introduce each other to alcohol and substances, form a tight group or gang where they are accepted, experience a sense of belonging, and identity. The shy, quiet child may find alcohol and realize she is funny and desirable and has a ball. The wild kid may become a powerful gang leader, use uppers and or smoke pot to calm down and feel one with the universe. Still others began addictive habits to numb their bodies, or to eliminate boredom, anger, depression. When this population reaches twenty-something, many will become troubled by addictive habits, wind up in AA or other self-help or treatment groups, either self-referred or court-mandated.

Final Thoughts: This all sounds simple, very pat and unrealistic when it definitely is not. A book could not do the topic justice. I intended briefly to demonstrate the complexity and co-created inevitability, almost natural evolution of a path to use and abuse addictive behaviors within the context of family/environment. Throughout this process I wanted to stress the presence of many, albeit unaware strengths of creativity, perseverance, courage, determination and awesome resilience that will assist the client to discover a clean and good life fulfilling his wants and dreams.

Let’s go: A life of freedom from compulsion is ready and waiting to be realized!

When I suggest to addiction trained and mental health professionals that there may be more for a sober client to attain in life than sobriety through the successful completion of the 12-step program in AA, I receive various responses:

1. Looks of incomprehension;
2. Questioning of my expertise and credentials in the addiction field;
3. “You are full of it”;
4. Tell us, please, we are tired of the same old; we have been sober for years and are still compelled to attend AA because we fear relapse if we don’t.

These responses are completely understandable. Personally, since 1981, I have worked long hours in the field of addictions. I developed addiction treatment programs, taught in many countries, and published. I cried with my clients, celebrated their hard-won successes, understood the obvious reasons for having developed addictive life styles, empathized, failed and learned continuously (still am), treated trauma with EMDR and struggled with health insurances. Yes, I know about the addiction field, the patients, and treatment approaches.

Please, hear me: The reality is that AA 12-step programs, other self-help groups, and/or religious affiliations have helped and saved many individuals from death; one cannot argue with these statistics. Others gain periodic sobriety and become caught up in relapse cycles; more are white-knuckling sobriety even while attempting to work the rigorous AA 12-step program but stay stuck; still others are developing cross addictions or, just never stop using. A patient once told me that he is addicted to AA. Addictions are considered an illness and treated as such by therapists, medications etc. The addict is the patient seeking HELP, professionals have the knowledge to help and if the client follows recommendations, he will recover. This is as it should be when treating an illness. However, even when recovery is successful, the client is admonished that “once an addict, always an addict”.

So what have I learned from my clients and what do I mean when I assert that the recovering person can attain a fuller life with life coaching than in recovery alone? That is a fair question and I am eager to share the good news.

What is Life Coaching for the Addiction-recovered Client?

Briefly, what I have learned over many years and other Life Coaches may assume that the sober client has gained a measure of personal and social stability; he is creative, resourceful, and competent. The life coach’s mission is to assist the client toward a satisfying, fuller life, forward moving toward authentic joy and happiness as defined by the client. They have proven that the “whole is greater than the sum of its parts”, meaning, they no longer must be labeled by their bad habits from the past. Recovery Coaches will recognize that the recovered client may still have lingering shadows from the past AND are aware that he has enormous strengths to put these shadows in a healthy perspective with determination, perseverance, courage, and hope. Without these attributes, they could not be where they are today. So where to go next to become more of what one already is?

Life Coaching may be the ideal “next step”. Each individual holds more potential, has more desires, and acknowledged (or not) wants, and needs, if given the opportunity to voice them to someone who truly hears without judgment, foregone conclusions, and the intention to “fix” it. Recovery Coaches are completely client oriented, and assist creating goals that have sound intentions and purpose for the life the client designs. The client will become gradually aware of differences as he lives the coaching process from the “inside out”. Minimally, the client will learn life skills so that he can make more choice-full and rewarding decisions in the future and reducing the engrained fear of relapse. Premier researcher and expert George E. Vaillant (1983), echoes Jellinek’s (1960) that addiction is still not understood and that the magic ingredient to keep the recovering individual in recovery has not yet been identified. Recovery Coaching may just provide that magic.

In summary, clients who have opted for life coaching are ultimately best qualified to comment on the good life they have created beyond sobriety and how pursuing and making meaningful choices have resulted in living a life of their dreams that is real, meaningful, and authentic.

____________________

[1]Vaillant, George E (1995) The Natural History of Alcoholism Revisited.[1] In this text, Dr. Vaillant offers various views on the perplexities of addiction, relapse, prevention, and treatment, given credence to both sides of the argument. Jellinek, E. M. (1960) The Disease concept of Alcoholism. In this books Foreword, Dr. Jellinek voiced discomfort with the concept of Alcoholism as a Disease and considers it a concept just as disease is a concept. He uses the word ‘disease’ reluctantly and under pressure of the Publisher.

Jellinek, E. M. (1960) The Disease concept of Alcoholism. In this books Foreword, Dr. Jellinek voiced discomfort with the concept of Alcoholism as a Disease and considers it a concept just as disease is a concept. He uses the word ‘disease’ reluctantly and under pressure of the Publisher.