(If you read this blog you probably like it, why not tell others about it, and make them follow it using the power of your charisma, I'd appreciate it. E-mail me if you have a question and I'll answer)
Question: My 28 year old brother just moved back in with our folks. He and his girlfriend had been living together and she always seemed really shady. She wrote us a letter claiming she caught him using heroin. My brother claims she is lying, but admits he has been feeling depressed. My parents are immigrants from Yemen and in our culture mental health issues and substance abuse are just not something you talk about. I'm afraid to let my parents help my brother because he might steal from them and take advantage of them. I'm afraid if we don't get him in treatment he is going to end up like those homeless addicts you see on that show intervention. I don't even know where to start!
Answer: Get your brother the help he is willing to take, and wait to trust him until he's earned it. The great thing about your situation is your brother has admitted he has a problem. No, it's not the problem that you are most afraid of, but if you can get him in treatment for the depression we are on the right path.
Most cultures have no conception of how to deal with mental health issues so you and your parents are not alone. The good news is there are culturally competent mental health professionals in every community. That does not mean they will be of your culture, but they will be able to work with its values and not in the face of them.
Do not simply encourage your brother to find a therapist, take next step and generate a list of names for him. If you have no idea where to start try your family physician, your insurance company, or an Internet search. Whether your brother is depressed or dealing with addiction he is unlikely to find help without support.
To prevent your brother from taking advantage of your parents insist that for the time being they never give him money. If he has a bill that needs paying that is his problem. If he claims it will ruin his credit, or they will take his car, many people have survived far worse. If your parents are determined to rescue him from his mistakes encourage them to write checks directly to the creditors, or to pay them with a credit card.
Make an inventory of everything precious that could be stolen from your parents house and sold easily and lock it up somewhere he cannot get access to it. If his feelings are hurt, and he reacts with indignation inform him that he has your permission to treat you in the same way if you ever move back in with your folks, and there are unsubstantiated rumors that you have used highly addictive drugs. Tell him that you understand his anger, and you hope that in three months you will be apologizing.
Trust is something that is earned not given. You love your brother, but once addictions enter the picture you would be very foolish to trust him. Addicts lie. They will do anything to get their need met and so until you are absolutely certain that he is healthy, stable, and on his feet you are better safe than sorry.
Showing posts with label addictions. Show all posts
Showing posts with label addictions. Show all posts
Saturday, February 13, 2010
Friday, August 28, 2009
just drinking a lot or drinking problem?
(If you like the blog please spread the word and sign up to follow it on this site or on facebook. If you would like a question answered or to set up a counseling appointment send me an e-mail)
Question: recently my husband has been drinking more and seems to try to hide it. He still seems to be functioning fine. I know he's not an alcoholic, but how do I know when to be concerned that this has become a drinking problem.
Answer: A person has a drinking problem when drinking leads to problems in their life. That answer is so simple that it may seem like I'm being facetious, I'm not.
Often people get lost in the details of semantics and word choice. What is the cut off between alcoholic and heavy drinker or eating disorder and disordered eating? To me at the end of the day when a person engages in any behavior that impairs their functioning, places stress on their relationships, is detrimental to their health, significantly impacts their finances, or any combination of these things, and yet they continue doing it, they have a problem.
I had a friend in college who had a B+ average. He went to class, had good relationships with people, stayed in shape, but two out of every three times he drank alcohol he would get in a fist fight or destroy property. Was he an alcoholic? Absolutely not. Did he have a drinking problem, YES. Fortunately after we talked to him he agreed and stopped drinking.
If your husband seems to be hiding his behavior you should absolutely be concerned about it because that means that he is. A rule of thumb for therapists is if you are afraid to tell your supervisor what you did you know you did something wrong. I think that maxim holds true for everyone.
There are two kinds of substance use, recreational and medicinal. When we use a substance in a social setting to enhance our experience and reduce our inhibitions this is recreational use. It may never be wise but at least this is usually the intended purpose of the substance. When we use any substance to change the way we are feeling, we are using it as a medicine. Any time we use "medicine", even those prescribed by a doctor, to get an effect that they were not designed for we are heading down a dangerous road.
For example if I have a headache from the stress of work and I decide to fix myself a cocktail to get rid of it I am using alcohol as a medicine. This can easily lead to a pattern where I increase my consumption as my stress increases and before long I have done damage to my body, my mind, and/or my relationships.
If you are concerned about your husband express it. Anytime we are afraid to bring a topic up with someone that is an indicator that we need to. Expect him to be defensive and counter that by pointing out your fears and ask that he merely look at it from your point of view. Hopefully he will decrease his consumption and replace alcohol with some far more healthy stress reliever.
Question: recently my husband has been drinking more and seems to try to hide it. He still seems to be functioning fine. I know he's not an alcoholic, but how do I know when to be concerned that this has become a drinking problem.
Answer: A person has a drinking problem when drinking leads to problems in their life. That answer is so simple that it may seem like I'm being facetious, I'm not.
Often people get lost in the details of semantics and word choice. What is the cut off between alcoholic and heavy drinker or eating disorder and disordered eating? To me at the end of the day when a person engages in any behavior that impairs their functioning, places stress on their relationships, is detrimental to their health, significantly impacts their finances, or any combination of these things, and yet they continue doing it, they have a problem.
I had a friend in college who had a B+ average. He went to class, had good relationships with people, stayed in shape, but two out of every three times he drank alcohol he would get in a fist fight or destroy property. Was he an alcoholic? Absolutely not. Did he have a drinking problem, YES. Fortunately after we talked to him he agreed and stopped drinking.
If your husband seems to be hiding his behavior you should absolutely be concerned about it because that means that he is. A rule of thumb for therapists is if you are afraid to tell your supervisor what you did you know you did something wrong. I think that maxim holds true for everyone.
There are two kinds of substance use, recreational and medicinal. When we use a substance in a social setting to enhance our experience and reduce our inhibitions this is recreational use. It may never be wise but at least this is usually the intended purpose of the substance. When we use any substance to change the way we are feeling, we are using it as a medicine. Any time we use "medicine", even those prescribed by a doctor, to get an effect that they were not designed for we are heading down a dangerous road.
For example if I have a headache from the stress of work and I decide to fix myself a cocktail to get rid of it I am using alcohol as a medicine. This can easily lead to a pattern where I increase my consumption as my stress increases and before long I have done damage to my body, my mind, and/or my relationships.
If you are concerned about your husband express it. Anytime we are afraid to bring a topic up with someone that is an indicator that we need to. Expect him to be defensive and counter that by pointing out your fears and ask that he merely look at it from your point of view. Hopefully he will decrease his consumption and replace alcohol with some far more healthy stress reliever.
Tuesday, June 30, 2009
self injuring sister
Dear Maigler,
Recently I went on a family vacation and I noticed that my younger sister has cuts and scars all over her legs. I had noticed marks on her arm before but she said our cat did it, and now I feel like an idiot for believing her. Does this mean she is suicidal or totally nuts, why would anyone do this to themselves?
Self-injurers Sister
Dear Sister,
Self injury is an unhealthy coping skill that becomes an addiction just like gambling, eating disorders, drugs etc... Is your sister in danger of killing herself? Possibly but without knowing more I would list her at the same level of risk as if you had found her dealing with one of these other issues. Most of the self injurers I have worked with are depressed but they generally do not want to die, they just want the pain to go away and self injury works for them in helping to manage their emotional pain.
My first recommendation is to talk to your sister about what you've noticed and how seeing that makes you feel. Ask her what it does for her and if she would like help in stopping. Offer to go with her to talk to your parents if they do not know about the problem, and if they do, offer to encourage them to get her into treatment.
Regardless of what she says (even if she begs you not to) you MUST tell your parents who should then get her in for an evaluation. Many psychiatric hospitals will do a free evaluation and if the person is not suicidal they will usually just help set up an appointment with a therapist in their insurance network. It may be a tense and boring several hours while you sit in a waiting room, and leave with a phone number but better safe than sorry. Call any hospital switch board and ask to talk to the intake social worker for psychiatric issues and you will get to someone who can guide you to your next step.
If you want to know more about self injury there are a number of great books out there. My favorite is called Bodily Harm by Karen Conterio and Wendy Lader http://product.half.ebay.com/Bodily-Harm_W0QQtgZinfoQQprZ839016 You can find it on half.com for 75 cents but it is worth it's weight in gold.
There is a misconception that self injurers like pain. This has not been my experience working with them. For most the act of cutting or burning does not actually hurt and for many seeing the blood or the scars helps them to have a visual representation of the emotional pain they are feeling. Most simply describe feeling overwhelmed and filled with pressure and the act of injury allows them to feel release, and many times this the only way they know to find peace.
The problem with self injury is that it works. Many of my clients will say “it's my body and I'm not hurting anyone else so everyone should just leave me alone.” Even if self injury wasn't dangerous, even if injurers didn't build up a tolerance and often need to use more extreme and intense means to get the same feeling, it still wouldn't be okay.
All addictions destroy relationships. I ask my clients how it would feel for them to watch their Mother, Father, or future children self injure?
“Would that be okay with you if they did it? I mean why not it works, and it is their body?”
For some reason I rarely find a self injurer who is willing to allow someone they love to inflict pain upon themselves and think it okay. BEWARE SPECIAL RULES! My self injury and eating disordered clients tend to play by a different set of rules than they hold for the rest of humanity. I tell them that when you do that you are cheating. As long as you were born on this Earth and not on planet Krypton you get the same rules as everyone else.
When I finally get self injurers to really commit to treatment it is because they have realized that as long as they self injure, even if hide it perfectly, they will never have a balanced and honest relationship while they are injuring. They will always be hiding and never sharing their true feelings. Any time they get an intense feeling of anger, sadness, shock,... anything but happiness, they will turn to their coping skill and not to their partner to deal with it. Most injurers have a history of emotional trauma, many were physically and/or sexually abused. They want connection but they fear it and they feel they are unworthy of it.
Reach out to your sister, say something. Every person who ignores the issue is reinforcing in the injurer's mind the idea that they and their problems do not matter. Self injury makes a lot of sense, it isn't crazy, but it isn't healthy and she could be choosing something better.
Recently I went on a family vacation and I noticed that my younger sister has cuts and scars all over her legs. I had noticed marks on her arm before but she said our cat did it, and now I feel like an idiot for believing her. Does this mean she is suicidal or totally nuts, why would anyone do this to themselves?
Self-injurers Sister
Dear Sister,
Self injury is an unhealthy coping skill that becomes an addiction just like gambling, eating disorders, drugs etc... Is your sister in danger of killing herself? Possibly but without knowing more I would list her at the same level of risk as if you had found her dealing with one of these other issues. Most of the self injurers I have worked with are depressed but they generally do not want to die, they just want the pain to go away and self injury works for them in helping to manage their emotional pain.
My first recommendation is to talk to your sister about what you've noticed and how seeing that makes you feel. Ask her what it does for her and if she would like help in stopping. Offer to go with her to talk to your parents if they do not know about the problem, and if they do, offer to encourage them to get her into treatment.
Regardless of what she says (even if she begs you not to) you MUST tell your parents who should then get her in for an evaluation. Many psychiatric hospitals will do a free evaluation and if the person is not suicidal they will usually just help set up an appointment with a therapist in their insurance network. It may be a tense and boring several hours while you sit in a waiting room, and leave with a phone number but better safe than sorry. Call any hospital switch board and ask to talk to the intake social worker for psychiatric issues and you will get to someone who can guide you to your next step.
If you want to know more about self injury there are a number of great books out there. My favorite is called Bodily Harm by Karen Conterio and Wendy Lader http://product.half.ebay.com/Bodily-Harm_W0QQtgZinfoQQprZ839016 You can find it on half.com for 75 cents but it is worth it's weight in gold.
There is a misconception that self injurers like pain. This has not been my experience working with them. For most the act of cutting or burning does not actually hurt and for many seeing the blood or the scars helps them to have a visual representation of the emotional pain they are feeling. Most simply describe feeling overwhelmed and filled with pressure and the act of injury allows them to feel release, and many times this the only way they know to find peace.
The problem with self injury is that it works. Many of my clients will say “it's my body and I'm not hurting anyone else so everyone should just leave me alone.” Even if self injury wasn't dangerous, even if injurers didn't build up a tolerance and often need to use more extreme and intense means to get the same feeling, it still wouldn't be okay.
All addictions destroy relationships. I ask my clients how it would feel for them to watch their Mother, Father, or future children self injure?
“Would that be okay with you if they did it? I mean why not it works, and it is their body?”
For some reason I rarely find a self injurer who is willing to allow someone they love to inflict pain upon themselves and think it okay. BEWARE SPECIAL RULES! My self injury and eating disordered clients tend to play by a different set of rules than they hold for the rest of humanity. I tell them that when you do that you are cheating. As long as you were born on this Earth and not on planet Krypton you get the same rules as everyone else.
When I finally get self injurers to really commit to treatment it is because they have realized that as long as they self injure, even if hide it perfectly, they will never have a balanced and honest relationship while they are injuring. They will always be hiding and never sharing their true feelings. Any time they get an intense feeling of anger, sadness, shock,... anything but happiness, they will turn to their coping skill and not to their partner to deal with it. Most injurers have a history of emotional trauma, many were physically and/or sexually abused. They want connection but they fear it and they feel they are unworthy of it.
Reach out to your sister, say something. Every person who ignores the issue is reinforcing in the injurer's mind the idea that they and their problems do not matter. Self injury makes a lot of sense, it isn't crazy, but it isn't healthy and she could be choosing something better.
Subscribe to:
Posts (Atom)
