For when life hurst too much not to change.
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WNY Physician Magazine, Finger Lakes Region, 2019

WNY Physician Magazine, Finger Lakes Region, 2019

Anxiety and addiction

First published in November 2015

Anxious, nervous, worried, on-edge, antsy.  Sound like anyone you know?  The thoughts won’t slow down.  A good night’s sleep is a distant memory.  Your heart is beating out of your chest.  There is a pit in the stomach and a clenching in the jaw.  The walls are closing in.  Where’s my closest exit, ‘cause I’m out of here?!  

Whatever you call it, in order to survive in the world anxiety is a normal response to threats.  When presented with a threat of harm to self or others, we got into the classic “fight or flight” mode.  These don’t have to be threats of physical harm, but mental, emotional, financial, or verbal.

At a training a few years ago, the presenter helped me to understand anxiety disorders more clearly.  He described the part of the brain that creates anxiety is like a car alarm.  Most car alarms only go off when there is a threat.  But you’ve heard that car alarm in the neighborhood that goes off in the middle of the night, every night, for no dang reason!  The alarm is hypersensitive.  The anxious alarm perceives a threat even when none exists, just a leaf blowing in the wind or a cat getting out of the rain.  Thus, someone with an anxiety disorder has a car alarm that’s too sensitive.

Others of us simply struggle with anxious worries from situations and experiences that we can’t control.  Either way, the feeling is uncomfortable at best.  Whether it is momentary on an occasion, or a day to day battle, anxiety leads many people to turn to unhealthy behaviors in hopes of some relief.

Individuals with untreated mental health diagnoses, unwilling or unable to access appropriate care, may choose to self-medicate symptoms with alcohol or other drugs.  To numb the feelings, escape the hopelessness and helplessness, to stop the voices; there are many reasons given to self-medicate.  Repeated self-medication can and often does result in the development of co-occurring disorders of alcoholism or addiction.

Alcohol is a central nervous system depressant.  It can cloud memory and increase depression.  But it also numbs emotional pain and decreases anxiety.  Hazelden reports that alcohol “provides a chemical cushion to ward off the emotional impact of everyday events.” This suggests it cushions symptoms of anxiety.

Marijuana is a mild hallucinogen with other depressant properties.  Time perception is altered, and less care is afforded to the worries of the day.  Using marijuana can facilitate relaxation in an individual with anxiety and/or sleep disturbance.  Nightly marijuana use to fall asleep can be very habit forming.  On the other hand, individuals with mental health difficulties may experience increased paranoia and agitation with marijuana use.

Benzodiazepines like Xanax and other anti-anxiety pills work in much the same way as opiates (like heroin).  Hazelden reports that individuals with PTSD may turn to these substances to cope with the anxiety evoked by flashbacks and nightmares.  They also remind us, though, that “benzodiazepines tend to reduce anxiety more quickly, but they also lead to ‘rebound anxiety’ when the medication wears off after a few hours, which can contribute to developing an addiction.”

When anxiety is at its worst, and the feelings are unmanageable with one substance, combining drugs may seem like the only source of relief.  Commonly, alcohol will be added to benzodiazepines.  The dangers are shared by which cites: “Alcohol and benzodiazepines can each harm the body, but the damage increases when they are combined. Since both substances are depressants, they can greatly relax muscles and bring the central nervous system to a crawl, which can result in unconsciousness or even a coma… Abusing these two substances in great quantities can also lead to massive organ failure and death.”


What is recovery?

First published July 2017

R: Resilience is “an ability to recover from or adjust easily to misfortune or change.” People in recovery, in my opinion, are Weebles. You recall from childhood: Weebles wobble, but they don’t fall down. This accurately describes the many clients I serve who are actively seeking recovery. None of the process is easy; it’s not sunshine and rainbows, but it is possible to keep fighting.

E: Effort is “conscious exertion of power, or a serious attempt.” The recovery process is simple. It has a set of steps and changes that can be followed by anyone. However, simple is not the same as easy. “Easier said than done” is a commonly heard phrase in my groups and individual counseling sessions.

C: Confidence is “faith or belief that one will act in a right, proper or effective way.” A range of attitudes could qualify as being confident, but without a balanced level of it, one is not likely to make long-term recovery sustainable. To have depleted self-esteem would derail the effort required. To be cocky would create risk for dangerous situations or complacency.

O: Openness is “not shut or locked.” Clients will often tell me that they’re completely open-minded; they’ll try anything once. But give them a suggestion to make their life better through therapy, spirituality or sober socialization and “oh no, that won’t work for me.” To be open in recovery means being mentally and emotionally accepting of others’ ideas, thoughts and suggestions. It is accepting feedback from others despite previously conceived notions one has about recovery.

V: Vision is “the act or power of imagination.” The clarity produced by detoxification from chemicals, elimination of negative influences and exposure to positive stories of strength, experience and hope allow an opportunity to create a vision of the future worth fighting for.

E: Enthusiasm is “strong excitement of feeling.” Opportunities abound in recovery: jobs, relationships, healing, enrollment in college, reuniting with children and on and on and on. While some of the aforementioned may also bring stress and anxiety, there is reason to be enthusiastic! When actively using substances or engaging in the lifestyle of an active addict/alcoholic, these opportunities are few and far between. They become realistic and achievable when in recovery.

R: Revitalization is “to give new life or vigor to.” The life of an active chemical user is a recipe for jails, institutions and death. A lifestyle of recovery brings a fresh start.

Y: Yourself is “your normal, healthy, sane condition or self.” Enough said.


Surviving the holidays

First published 2015

The Holidays are coming!  The Holidays are coming!  Does that fill you with joy or dread?  Each of us comes to the holiday season with a different set of circumstances and related emotions.  Whether in recovery from alcohol, drugs, mental illness, or a combination thereof, the holidays can be a challenge to prevent relapse.  This article’s intention is to offer suggestions and encouragement to manage the season this year so that you can continue to look forward to Spring, Summer, Fall, and the many holiday seasons to come.

It is normal to feel the blues as holidays roll around.  Special days remind us of those not able to spend that time with us; remind us of time passed and opportunities lost or long-gone.  Or maybe you love the holidays but living in Central NY has depleted your Vitamin D so much you just don’t feel up to it this year.  Whatever the reason, don’t stress the small stuff.  

Many individuals in early recovery feel a sense of urgency at the “first” set of holidays.  The need to buy a hoard of gifts for the kids, make the best meal, and see every family member they have is pushing them to the limits of their sanity.  “I wasn’t able to be there last year,” is a common reason for this sentiment because of incarcerations or institutionalizations related to addiction issues.  Early recovery, though, often finds one unemployed or underemployed because treatment and stability of the disease is paramount priority.  The stress, then, of being able to give ones family the “Christmas they deserve for dealing with me” is unmanageable.  I’d be willing to bet, though, if you asked your children they’d want to be with you more than any material good.

Holiday parties at home, work, family, etc, often involve alcohol use.  The Thanksgiving Eve happy-hour, wine with holiday dinners, Christmas punch, a hot-toddy, and champagne toasts at New Years are just a few examples.  It is important to get prepared and have a Relapse Prevention Plan in place so that successful celebrations can be had!

Tip 1: Take an inventory of your motivations for attending.  Is it the open-bar?  The crazy group of friends you haven’t seen in years?  An obligation to the boss?  Or, a sincere appreciation for the other attendees or host?  If alcohol use, or the opportunity to use, is a primary motivator to attend: Reconsider!

Tip 2: Talk with the host(ess) ahead of time and express your position.  This may not be comfortable if it’s a work party, but for family and friends you need to speak up.  If you don’t believe that the host will be respectful or responsive to your needs, reconsider why you’re going in the first place.

Tip 3: Bring a sober support person with you.  Most invitations come with a “plus-one” so take advantage.  You’re less likely to be tempted by alcohol or drug use if a support is watching nearby.

Tip 4: Have reliable transportation.  You don’t want to get stuck in a high-risk situation.  If you don’t drive, make sure that the ride you’ve arranged is ready and willing to leave upon your call.  Bring taxi-cab numbers or have a local bus schedule.

Tip 5: Always have time schedules for each event.  When will you arrive?  When will you leave?  Most events that involve alcohol use get progressively more out of control as the night wears on.  That means you could probably participate in dinner and any speeches or formal events and then leave as others get rowdy.

Tip 6: Go to a 12 Step Meeting beforehand.  If you get a great-big dose of recovery before the party, the spiritual principles will be fresh in your mind when you get there.

Tip 7: Take emotional inventory.  Know what you’re feeling and why you’re feeling it.  Then figure out the healthiest response to that feeling.  Ask for help when you need it.

Tip 8: If in doubt, don’t go.

Remember, the holidays don’t come in bunches that have to be seen as stressful or risky.  Each holiday is just another “one day at a time.”  Recovery is a matter of having a plan to be abstinent for just that day.  Anyone can conquer one day, with use of the tips above and many others from those who’ve lived it.



December 4, 2017

Colloquially it is recited that “the first step is admitting you have a problem.” Not true. The first step is “We admitted we were powerless over alcohol, and that our lives had become unmanageable.” I can say I have a problem without even coming close to admitting powerlessness and unmanageability. There is an acceptance and ability to move forward that comes with surrendering to the concept of powerlessness.

The only things of which we can claim to have power over are the things in life which we can change and control. We are powerless to snow storms, illness, death, how others think and act, etc. We have power over our attitudes, how we respond to life and others, when we take action and when we sit back, and so on. defines powerlessness in two ways: 1) inability to produce an effect; and 2) helplessness. Both ring true with addiction to alcohol or other drugs. An alcoholic may have a desire and motivation to stop drinking or to control his drinking in order to avoid consequences, but he cannot do so. A heroin addict, because of his powerlessness over the drug, feels that sense of helplessness; not being able to make change on his own and believing that nothing can get better. Years and years of attempts to gain control and power over one’s drug of choice leads to, in the First Step, an admission of powerlessness.

Powerlessness is not weakness. Rather, to be able to admit one is powerless is to be strong enough to know ones limits and to then seek the help necessary to change. Bradford Health Services explains it like this: “While it is important to believe in your ability to overcome your addiction, you first must admit that you have an addiction and you need help in order for things to change. Until you do so, drugs and/or alcohol will continue to exert their power over you and control every aspect of your life. The power of admitting powerlessness is that it is the first step to taking back your life.”

Powerlessness is not defeat, but it is a sign that a war need to be fought. You can never be sure you’ve won the war with addiction and alcoholism, but you can win the day to day battles through a recovery lifestyle.

Powerlessness is not a lack of will. It is acknowledging that the drug (alcohol included) has grown stronger than you can manage. In simplistic terms, I liken it to when a sweet puppy grows to be bigger and stronger than its owner. I may will the dog to follow me and obey my commands, but I don’t have the power to pick him up and move him.

Why is it so hard to admit powerlessness? Just take a look around at the messages our culture gives us about who is in control of their own destiny: you are. Duct tape can fix anything. There is a pill for this. There is an app for that. We are expected to not need or ask for help. American culture frowns upon anything that doesn’t seem pioneering.

Once we can admit and accept our powerlessness, we can begin to get results in recovery.


November 25, 2017

Have a slice of humble pie.  Get down off your high-horse.  Pay attention to the log sticking out of your eye instead of the speck in someone else’s.  We have a lot of ways in our culture to encourage a prideful person to get a little humility.  But let’s stop focusing on others and start identifying it in ourselves.  Are we humble?  Can we see ourselves as we truly are, not exaggerating the strengths or failures in any way?

Humility is a truly spiritual component of recovery.  It cannot be judged by others and is not an active behavior but an attitude and way of viewing oneself.  To be humble is to say that I am no better, nor worse, than anyone else; I have character strengths and defects just like everyone else.  To have humility is to live in an attitude of gratitude for who I am, where I am, when I am there.  It is not a constant focus on what I want or wish I was.

Alcohol and drug use can damage ones pride in significant ways, causing a feeling of humiliation.  Humiliation is not the same as humility.  Damaged pride makes me feel small.  Humility makes me feel the same as others, and them me.

In early recovery it can be tempting to replace damaged pride with an ego; a mask that tells the world how I want them to see me.  Wearing a mask does not allow me to be honest with myself or others, or to be express gratitude for my true place in the world.

I have a Higher Power who loves me, and he loves you, too.  We are equally worthy of that love.  When we humbly accept that love, recovery’s spiritual awakening is possible.


Being assertive

November 20, 2017

Are you a door mat or an impenetrable wall?  Neither?  Depends on the circumstance?  Let me ask it another way, are you passive or aggressive?  Passive aggressive?  If you are uncomfortable identifying yourself in any of these ways, maybe you’ve learned that neither is a healthy way to communicate and interact with the world.  Rather, being assertive (aka firm, respectful of self and others, self-advocating) is a healthy option.

Examples of passivity: allowing someone to dictate your thoughts, feelings, and behaviors; not standing up for oneself or what one believes in; or always giving in to someone else’s whims even if they are uncomfortable or unwanted.

Examples of aggression: name-calling; physical threats and violence to get one’s way; or overt disregard for others.

Examples of passive-agression: the cold shoulder or silent treatment; sarcasm and rude humor in front of others; or procrastination on tasks that are important to others. 

To assert oneself is to stand up for ones beliefs in a way that is respectful of self and others.  There is no name-calling, threats, or unvoiced need in assertiveness.  For example: I believe that my opinion is as valuable as someone else’s.  To express my opinion, I do so with a calm demeanor, concise statements, and without telling the other person “you’re wrong.”  I don’t disrespect their position, nor do I allow them to disrespect mine.

In today’s culture, we could all benefit from developing assertiveness as our main style of communication.  Start by learning “I-statements;”  I think, I feel, I believe, I learned… etc.  We are less likely to offend or raise defenses in someone else by expressing our own opinions in this way.


What works and what doesn't: Parenting an Addict

October 31, 2017

Around the country, parents can be heard saying the following about their addicted children: “What did we do wrong?” “How did I not see this happening?” “Just stop and act right!” “Go to treatment or get out.” And everything in between.

Geoff Kane, M.D., MPH, wrote for the National Counseling on Alcoholism and Drug Dependence: “People who are close to individuals with active addiction sometimes have to make high-stakes decisions. Desperate situations compel them to act, and then leave them hoping and praying for a positive outcome. Parents’ decisions may be the toughest, regardless of the age of their child. 'Will giving support right now save my child — or be enabling and ultimately destructive?' 'Will withholding support right now save my child — or precipitate disaster?'

“At such times it can be prudent to avoid all-or-nothing responses in favor of a sequence of limits and consequences. That way success or failure is not determined all at once. Success — safe recovery — then depends upon all concerned continuously making adjustments to maintain balance between clear-cut expectations and consequences,” Kane stated.

Further, Kane noted, “Recovery is primarily an individual responsibility and treatment is primarily a professional responsibility. Successful recovery, and therefore successful treatment, depends upon all concerned continuously making adjustments to maintain balance between clear-cut expectations and consequences.”

I spoke with several clients about what their parents did that worked, and what didn’t work. Here are their responses:

What worked

• "Told me that they love me no matter what and are not ashamed of me and will support me in anything."

• "Joined a support group for their own knowledge and awareness of the disease."

• "Took me to meetings but didn’t push to know what I talked about."

What didn’t work

• "Telling me I 'ruined' the family."

• "Telling me they are going to die soon because of the stress I’ve put them through."

• "Calling me an embarrassment."

• "Enabled me by preventing me from having consequences."

• "Treating my sibling differently from me."

• "Being bitter and demeaning."

• "Sharing all of my struggles with their friends and other family to humiliate me."

The truth is, the most important thing a parent can do is love their child, whether they are still a teen or an adult. That love can be shown by parents in many ways including: verbal affirmations, becoming addiction and recovery experts in their own right, taking care of themselves, and setting healthy boundaries.

Recovery is possible for the whole family. Let love lead.

Sleepless nights

October 9, 2014

I spent most of last night tossing and turning... rolling over in my mind the things I haven’t been doing well.  Promising myself that I would make change immediately (as soon as I get some sleep).  I caught a couple of winks and woke up dreading making change.  Alas, change is hard... even when you know its the only thing left to do.

Have you had nights like that?  Many of them in a row?

The truth is, we all do.  Surely these nights are obnoxious, but they are also a strong indicator that the time has come to do something differently.  Here’s what I’m doing this morning:

Make a to-do list

Let my husband know where I’m at.  He’s my support and accountability

Reality check of where my concerns are at; making notes so I don’t forget

Asking for help to address the things I cannot change and making commitments to change the things I can.

--Ready to join me?




first published 11/2016 in the Auburn Citizen

Dear clients,

Thank you.

Thank you for allowing me to use my gifts, talents and skills. By the age of 12, I knew “what I wanted to be when I grew up.” Your presence in my office allows me to fulfill my dream.

Thank you for forgiving me for being human, for allowing me to have the occasional bad day. When I come in grouchy or annoyed by the traffic, you are patient with me. The days a bug has taken away my voice, you listen more attentively (though I know you are also really enjoying the change!).

Thank you for forgiving me when I don’t have all the answers. Because I don’t have all the answers. I can use the Google machine with the best of them, but more than that I seek out answers from other community service providers who are experts in their fields. When I don’t have the answers, I know someone will. We will find the answers together.

Thank you for letting me see you make progress. Sometimes in life, and work, we simply get the pleasure of “planting seeds we never see grow.” But when you stay with me long enough for the seed to be nourished by its many resources, I get to observe beauty; I get a courtside seat to God’s plan unfolding in your life.

Thank you for trusting me with your fears, secrets, resentments, lofty goals, hopes and dreams. I hold your confidences with pride.

Thank you for letting me in. When you open up a window in what was previously a steel-reinforced fortress, I am grateful. I understand how difficult this type of vulnerability is and don’t take it lightly.

Thank you for keeping me on my toes. Just when I think I’ve heard it all ...

Thank you for teaching me. You teach me every day. I learn about you and your experiences. I learn about the diagnoses we treat, but more so about the humanity in each of us. Considering a new perspective pushes me out of my comfort zone. You teach me, too, about myself personally and professionally.

Thank you for your honesty. It is never easy to be honest and know that there will be consequences. It is never easy to be honest and feel the guilt and shame of one’s past. But the reality becomes that it is honesty that sets us free to make more progress, to grow more beautifully than we could imagine.

Thank you for making me laugh. Oh, do you make me laugh!

Thank you for engaging in growth, learning and processing. Whether we meet once, twice or 100 times.

Thank you.




Dignity & respect

first published 5/2014 in the Auburn Citizen

Dignity. Respect. Two qualities with which all people deserve to be treated. All people, based solely on the fact that they are human. While I believe this wholly, it can be challenging to act upon when others don’t treat themselves with dignity or respect.

This challenge appears regularly in the field of addiction treatment. Clients come in with little to no self-esteem or self-care. They’ve put their chemical ahead of all other needs (relationships, employment, parenting, etc.), but this does not make the addict/alcoholic any less human — any less deserving of dignity and respect. So why is it difficult for the rest of us to see them and treat them as such?

In many cases the addict’s loved ones may be sick and tired of treating the addict as a human being. They’ve stopped seeing son, daughter, spouse or friend. They only see the disease. When this becomes the case, generally after years of trying to help enough, love enough, give enough, the addict is treated without dignity or respect. The human the loved ones knew no longer seems to exist. The diseased brain then tells the addict that “no one understands you like I do.” Thus, the cycle of chemical use continues: Hurt the people you love, get drunk to feel better, give in to the disease, lose more of yourself, get drunk to feel better.

How, then, is an addict/alcoholic expected to begin a recovery lifestyle? They’ve come to believe and be treated as though they are less than human. How are they to do the hard work of living as though they deserve dignity and respect? The answers may lie on a variety of levels, from the individual to the greater community and society.

If the addict can accept a recommendation for treatment, regardless of motivators, they may enter a program where staff treats them with dignity and respect. They’ll have an opportunity to learn about their disease and that they are worthy of recovery, no matter their past.

An addict who becomes willing to participate in mutual-help groups, such as Alcoholics Anonymous or Narcotics Anonymous, will find a fellowship of people who “get it” and will love the addict until they are able to love themselves.

If you love an addict, you’ve been negatively impacted by their disease. Breaking down one’s own wall of denial becomes key here. Loved ones can help make change by caring for themselves, addressing how the addict’s disease has also made them sick. If you’ve developed anger or resentments after years of being lied to and having your possessions sold for chemicals, you’ve been sickened by the disease. As a result, the whole family needs a recovery program. Ala-non, Ala-teen, and treatment facilities with family programs can assist in the process.

The stigma that surrounds addiction in our community carries on the idea that an addict/alcoholic is “a bum” or a less than equal member of society. For the addict to begin the recovery process, to treat him/herself with dignity and respect, this must change. In many cases, the addict in our community is a teacher, a doctor, a lawyer or a therapist. Of course, others are repeatedly in the news for criminal behavior. The point is that addiction is a disease that does not discriminate among human beings. It simply seeks to bring suffering and death to all.

Recent initiatives by the Office of Alcoholism and Substance Abuse Services Committee in Cayuga County, including several community representatives, have shed light on opiate addiction. Has that begun to reduce stigma? In some cases it may be that hearing more about outreach and prevention efforts lessens the stigma by making the topic less taboo. In other cases, some are using it as a way to bolster their beliefs about addicts — "the junkie." I believe more efforts should and will be made to raise community awareness and reduce stigma.

Developing a community in which all humans are treated with dignity and respect will also require those in recovery to advocate for their fellowship; to share their strength, experience and hope with anyone who will listen. Recovering addicts/alcoholics cannot stand by and expect stigma and disrespect to change.

Each and every one of us can make a difference. We can begin to treat ourselves with dignity and respect and soon this behavior will transfer to others, and hopefully to all. Dignity and respect won’t cure the disease of addiction, but it will certainly go a long way to promote recovery as a lifestyle.