Category Archives: Compassion for self and others

Bonus post: Kindness advent calendar

acts-of-kindness-calendarI’ve had a really tough week and MrHOF very kindly took the HOFlets swimming this morning so I had a bit more extra time for soberverse browsing.  While I was dipping in and out of sober communities I spotted this December kindness advent calendar that someone on Soberistas had shared and I thought ‘how lovely’.

When we’re stuck in the ‘pity party for one’ space it can be all get a bit me me me – well that’s my perception anyway! 😉  Sometimes focusing on something or someone other than ourselves can be really emotionally beneficial and this is the perfect way to do that.  So I’m going to be consulting this every day from now until Xmas too as a way of warding off those potential ‘woe is me’ moments.

I also found this on the wonderful interwebs at 12 kinds of kindness:

A 12 step experiment designed to open our hearts, eyes and minds

So as December 1 asks on the Kindness Advent Calendar I have shared this with you to encourage others to practice kindness this month.  As the calendar says in a final quote from Lao Tzu:

Kindness in words creates confidence

Kindness in thinking creates profoundness

Kindness in giving creates love

Thank you to the kind Soberistas who shared this and therefore allowed me to share it too 🙂

Friday Sober Inspiration: Is there a formula for happiness? (Come As You Are)

TheHappinessEquationI read this article a few weeks ago because of the subject but also because one of the writers is an old friend of ours who we’ve lost contact with.  It was lovely to connect with her again through reading her words.  Plus the first contributor is also in recovery so it felt doubly apt to share it here.  It was in The Telegraph and looking at whether there is a formula for happiness.

A new publication, The Book of Joy, written by the Dalai Lama and Archbishop Desmond Tutu, has sparked debate over their theory that joy can be achieved by embracing “eight pillars of joy” – these being perspective, humility, humour, acceptance, forgiveness, gratitude, compassion and generosity.

Here, four writers discuss their own rules for happiness.

‘I found happiness when… I learnt to be unhappy’

Bryony Gordon, 36

A friend of mine in recovery once said to me that to be truly happy you had to hit rock bottom. I didn’t really understand what she meant.

Perhaps that’s because I was drunk or high at the time – it was many years ago, when I would self-medicate my obsessive compulsive disorder through alcohol and cocaine, and everyone wanted to be my friend ‘because you’re so fun!’.

I thought fun equated to being happy. I was wrong. It’s only after five or six breakdowns (I lose count) that I have realised that the real key to happiness is to embrace unhappiness – to allow yourself to go to that rock bottom my friend mentioned without trying to shoo it away.

You don’t take your unhappiness and try to water it down with five pints of strong continental lager. You don’t run away from your unhappiness towards the nearest drug dealer.

You sit with your unhappiness, no matter how much of an arsehole you think it is. You talk to your unhappiness, however creepy it makes you feel. Maybe only for an hour each week, with a therapist there, but you talk to it all the same.

Try to at least make an acquaintance of it. Get to know it. Attempt to work it out, so it doesn’t keep getting the better of you. I did this last year when I wrote a book about my mental health, Mad Girl.

It made me very unhappy. Depressed even. Sitting with your unhappiness day in, day out is difficult, like scratching away at a scab. 

Even when the book came out at the beginning of the summer, I had not learnt properly how to deal with it. How to cope with it. But being able to cope with unhappiness is, I realise, all that happiness really is. It is nothing more complicated than that.

To find yourself in a real bind, wondering how you might get out of it, and to realise that you do not have to. You can just ‘be’ and not beat yourself up for just being.

And one day you catch yourself, maybe when you are having lunch with your family or watching someone you love run free across a park, and you get a pang of a memory of the misery you once used to feel all the time. You don’t freeze. You don’t panic. You say, ‘Hello unhappiness, my old friend. How are you?’

Then you smile, and you get on with your day. 

The other contributors are:

  • Elizabeth Day
  • Kerry Potter 🙂
  • Laura Powell

I particularly liked the last box:

It’s okay to embrace your darker side

Learning to cope with emotional states such as anger, envy and boredom can boost happiness, according to Dr Tim Lomas, psychologist and author of a new book, The Positive Power of Negative Emotions. He argues that allowing yourself to feel darker sensations boosts those feelings of joy and elation and can spark them too.

“Often people will think that if they feel pessimistic then something must be wrong with them and they shouldn’t be feeling like that, but negative feelings can send a useful message,” he says. “For example, if you feel lazy it might be more pleasurable to stay at home, but if you go for a run, in the long-term your wellbeing will be better served.”

Dr Lomas says the same is true for more complex emotions. “Take guilt: it can be unwarranted, but it also tells us important information about ourselves, ways we have gone wrong in the past, and make us be better people in the future.” Accepting negative emotions can make you more appreciative of positive experiences.

And in that spirit only Nirvana fits 😉

 

Shoot the Damn Dog

shoot-the-damn-dogBack in June I blogged about the sad death of Sally Brampton and at the time added her book to my reading wish list.  ‘Shoot the damn dog‘ finally arrived from the library and oh my goodness what a beautiful book.  It should be mandatory reading for each and every one of us depressed, drinker or otherwise.

She was the most eloquent of writers and this book is poignant, honest, heartbreaking and brave.  She does for depression what we try to do out here about booze – tell our story in the hope that it helps someone else who recognises themselves in our words.  I saw myself in Sally’s experience and I could quote huge swathes of this book exclaiming ‘me too!’

I shall desist apart from to share brief excerpts as to why she wrote the book, her experience with booze and therapy.

So why am I writing this book?  I’m writing it because although I dislike the confessional, I was (and continue to be) so repulsed by the stigma around depression that I determined I must stand up and be counted, not hide away in shame. …… I wish I could say it was bravery that drove me to pin myself like a butterfly to the pages of a national newspaper, but it was actually anger.  I admit that my anger took me by surprise.  But then, so did depression.  I had never thought about its implications, or its consequences.  The more I inhabited it, the more I came to see the fear and shame surrounding it.  The more depressives I met, the more I came to understand  that we are not simply fighting an illness, but the attitudes that surround it.”  Replace the word depression with alcoholism and all of that could have been said by me, here.  I share her anger at how those of us who become alcohol dependent can at times feel stigmatised and ashamed.

I am drunk, I think, because I learned to use alcohol to try to crush my pain…… I learned that alcohol is the best anaesthetic in the world.  If I drank, I did not feel……. And I knew, in that part of my brain that was still robustly sane, that alcohol would not free me from the pain, except temporarily.  I knew that alcohol was a depressive, that I was taking an anti-depressive pill with one hand and a bottled depressive with the other.  And I also knew that I was trying to kill myself.  Alcoholism is a slow, ugly form of suicide.

As my shrink explained, ‘ You have to find your way into alcoholism which means drinking sufficient amounts to develop a dependency.  Why you do that is open to interpretation.  But once you have developed a dependency, you have an addiction not only to alcohol but also to a pattern of behaviour.  The only way out of addiction is to stop the substance abuse, and to learn new ways of behaviour.’  Shrinks call depressive drinking, ‘self-medication’.  I could stop for a day, a week or a month.  I could stop drinking for 3 months or even six.  Stopping is easy.  Staying stopped is overwhelmingly difficult if you are drinking to stop pain.”

Every addiction is a manifestation of emotional distress.  Nobody becomes an alcoholic or a binge eater because they love alcohol or food, they simply use excess alcohol or food to dull the pain that they are unable to express in words.  Most of this, of course, is unconscious.  If I am in emotional pain, my instinct is to take it away.  My way of doing that is to drink, as I have learned that it relieves (if only temporarily) my pain.  I have learned a disorderly habit of behaviour, that, once learned, is difficult to dismantle.  It is a condition, an emotional illness or a behavioural disorder.  It is, if you like, an inappropriate response to difficulty or pain.  It is the messenger, not the message.  Now that I am well again, perhaps I could drink again.  It is simply a risk that I am not prepared to take.

Yes to all of the above.

Looking at our own selves is horribly difficult to do, requiring a level of honesty and humility that can at times feel unbearable.  Few people are prepared to engage with it fully but without it, I truly believe that we cannot be happy…..  Therapy helped, but it is not magic.  It does not change our thoughts and behaviours.  It only teaches us what they might be.  It does not work unless we take from it what we have learned and put it into action.  So it is not, as so many people seem to think, a piece of indulgent navel gazing.  Nor is it about blaming the parents.  It is, I’d say, quite the opposite.  It is about understanding and accepting our parents.

There is a saying, ‘it’s never too late to have a happy childhood‘.  I’d rephrase that.  I’d say, it’s never too late to stop a difficult childhood from turning us into unhappy adults.  A difficult childhood may have set up a series of behaviours and responses that leads us to repeat those same patterns in our adult lives.  That does not mean that we have to continue those patterns.

I was given a birthday card with those exact words on during the first years of my recovery not just by one person but two – MrHOF and my sister.  The identical card by two different people, who are both very close to me and know me very well, on the same birthday!  It is on the wall above my desk …..

There is so much wisdom in this book I really do urge you to go read it in it’s entirety .

Friday Sober Inspiration: Abundance

abundance-scaleSo this image is taken from the book Money Love by Meadow Devor who was interviewed by Tommy Rosen as part of his Recovery 2.0 online conference in September.  She was talking to him about financial sobriety and some of the things she said had my mouth fall open in recognition.  So I thought I would share a few key points from what she shared about abundance, compassionately observing and noting our thinking and moving on from the ‘please like me discount’.

Although her book focuses on money so much of what she said is applicable to so many other areas of life too, including booze.  Interestingly Meadow is also in recovery from alcohol.  So without giving away too much – these were my key take-away points from her wisdom.

When you engage in a behaviour whether it is spending, eating, drinking, internet surfing, etc ask yourself:

  1. What are you feeling?
  2. What are you trying to achieve/avoid? Why are you doing this?
  3. Can you afford it? In terms of money, time or emotions

And to weigh up the value vs the cost (again talking about financial, time or emotional).

She also talks a great deal about how we act from either scarcity or abundance as represented by the scale illustrated at the top of the post.  I definitely grew up with a scarcity mentality and mindset and have been doing some serious work around reframing how I view the world in a more abundant way.  Part of that work was leaving behind my own ‘please like me discount’ which, because of my own issues with co-dependency, was a big thing that I knew I did but had never before heard it put so succinctly into words!  I have a post it note above my desk that reminds me:

You do enough

You have enough

You are enough

You can listen to her being interviewed by Laura McKowen & Holly Whitaker on the Home podcast here:

If you are struggling with feelings of worry, frustration or lack how about trying this abundance meditation to see if you can start to shift your way of thinking too?  I can promise you if you begin to practise gratitude, and try to engage with the world from a place of empowerment and abundance soon the ‘fake it till you make it’ approach will shift becoming not just a desired hope but your reality.  Why not give it a try?

PS As if our cup wasn’t overflowing enough with abundance today this news broke this afternoon too! Go Scotland!! 🙂

Plans to set a minimum price for alcohol in Scotland have today (21 October 2016) been backed by the Scottish courts.

“We are satisfied that the Scottish courts have concluded that MUP is legal, as we have argued for many years, and we now call for it to be implemented without delay.” (Herald Scotland)

 

Friday Sober Jukebox – Escape Velocity

escape velocitySo here we are again now heading into year 4 🙂

There are many things I still haven’t covered on this blog so until I run out of new things to share and say a post will keep appearing,  probably on a weekly or two weekly basis, depending on what’s going on.  Plus I know myself well enough now to know I won’t be able to keep my big mouth shut about any major news story that breaks in the alcohol and public health worlds!

So today is about psychological escape velocity (the minimum speed needed for an object to escape from the gravitational attraction of a massive body).  I had a headf*ck experience recently where I was given the opportunity to see photo’s of a house I lived in when I was a girl.  What was really spooky and serendipitous about this was it was via a nursing colleague who had lived in this house about 20 years after me, had taken photo’s and had recently been sorting through them and happened to have them with her in the office then and there that lunchtime!  Weird right?

What she didn’t know was that I have really distressing and traumatic memories of this house and time and have spent a good amount of time in therapy talking about it so seeing those images triggered an avalanche of memories.  What was so reassuring was that although the memories had only been experienced in the last 5 years (which fuelled a massive amount of drinking back then) my recall of that house was EXACTLY right.  Every detail that I had summoned from 40 years ago and discussed was spot on – so if my memory of the place was right so was my recall of the events.  This was a major revelation because at the time when I tried to tell someone I hadn’t been believed and I had therefore doubted my own experience and had questioned whether it was all just in my head – that my nightmare’s were just that horrors in my head not real life.  Although seeing the photo’s caused intense psychic tremors I was okay and I was able to regulate my emotions and handle the triggered distress.  This felt like massive progress to me and as if I had enough emotional and boundary depth to not be pulled back into the psychological pain of that time.  These events no longer defined me – I had reached my psychological escape velocity 🙂

When I told MrHOF he said this was not just the end of a chapter but the end of a volume in my life and he felt it was no co-incidence and a sign from the universe (because I believe in such stuff) that that experience and how I managed it marked closure both emotionally and mentally for me and that I wasn’t doing a geographical by planning our move to Australia.

That same day I was contacted by Regina Walker at The Fix who is a psychotherapist.  I was reading her writing archives when I came across an article about Dialectical Behaviour Therapy (DBT) a technique used in the UK mainly to treat those with borderline personality disorder.  Thanks to my research assistant experience with a Clinical Psychologist who worked with this client group it was something I knew about, knew it was a successful and valuable therapeutic approach and learned from this discovered article that it is being used and applied in addiction!

Here are the key excepts that link my experience recounted above and this technique (the whole article is well worth your time in reading):

The goal of DBT is to acquire skills to deal with the mental anguish the sufferer experiences and create a life worth living. The tools offered in DBT are meant to aid in the achievement of these goals.

DBT, for people struggling with substance abuse problems, is a way to achieve self-acceptance while simultaneously accepting the need for change. There are four basic aspects to DBT: mindfulness, interpersonal relations, emotion regulation, and distress tolerance.

The emotion regulation aspect of DBT teaches how to identify, regulate and experience emotions without becoming overwhelmed and acting on impulse. The skills aim to reduce vulnerability and increase positive experiences.

The fourth area of DBT is distress tolerance. This area is focused on the development of skills to cope with crises when emotions become overwhelming and the individual is unable to immediately solve the problem (a death, sickness, loss of job, etc.) but needs to persevere and live through the crisis without making it worse by impulsive actions (for example, getting high or drunk).

Dr. Linehan acknowledged that the self-harming behavior she saw in suffering patients made sense and had a purpose.  But she also recognised that this had to change and that the person had to accept themselves.

She referred to this as “Radical Acceptance”—acceptance of life as it is, not as it is supposed to be; and the need to change, despite that reality and because of it. These seem to be opposites: on the one hand, you have to take life as it is; on the other hand, that change is essential for survival. But for real change to happen, both self-acceptance, and acceptance of the need for change have to come together. This blending of two seemingly opposite views is called a dialectic—and it’s the vision behind the name of Dialectical Behavioral Therapy.

So after 3 years of living life sober, and ‘in the raw’ as Mrs D would say, I have both accepted myself and what happened to me as a child and shown myself self-compassion.  I have taken life as it is but recognised that change was essential for my survival.   My psychological escape velocity from my past, and as part of that alcohol, has reached a critical juncture 🙂

In the past those photo’s would have rocked my world in a very negative way and triggered the most almighty bender.  Now I just feel peaceful and content that I can trust myself to take care of myself as I tried to as a young girl.

Friday Sober Jukebox – Broken Stones

sally bramptonSo with a week to go before I hit 1000 days I’ve become very reflective and the recent news that Sally Brampton walked into the sea not to return made me both profoundly sad and introspective.  This image is taken from her blog and I believe it is her sat on the stones and pebble beach near where she lived.  I used to love reading her column in The Sunday Times Style as she was so full of wisdom and compassion.  Her own ongoing struggle with depression and her past battle with alcoholism was known and added to, not took away from, her ability to offer comfort and advice.

She renounced alcohol in 2003.  ‘It would take three years and a 28-day spell in rehab for alcoholism, as well as attendance at AA meetings, for Sally to recover completely.’ (Daily Mail)

This is the post that remains on her website and resonates so strongly for me:

This is where I write about pretty much everything I love; usually emotion, because I think that’s where we all connect. I write about depression because I have depression, and I think it’s good to talk about it. Sharing can bring us out of the dark and into the light. That’s why I wrote a book about it; Shoot the Damn Dog, and I am pleased and honoured that it helps so many people, who write to me sharing their experiences. I wish I could reply to every letter, but I simply can’t, because there are so many, but sometimes, it’s just good to get our thoughts down on paper. It makes us feel less alone and I hope it helps you as much as it helps me to know that we are in this together, and that there are people who truly understand.”

Obituaries were written by The Guardian, The Telegraph and The Independent.

But the most poignant was the page dedicated to her in The Sunday Times Style magazine a few weeks ago which shared some of her gems of wisdom from her column that ran for 8 years to ‘celebrate her infinite wisdom.’

Sally Brampton RIP 2016

This tune played recently on my rounds and it felt apt – the lyrics, the images of the beach and sea and so I share it here in memory of Sally.

Rest in Peace.

 

7 Things That Happen When You’re The Child Of An Alcoholic

adult child of alcoholics characteristicsThis was on BuzzFeed in February sharing the experience of being the adult child of an alcoholic.

My dad was an alcoholic.

Not the suave chain-smoker who drinks whiskey from die-cut glasses, nor the sardonic barfly in khaki trousers whom everybody keeps around because they’re just so loveable.

My dad was the kind of alcoholic who fell over in the street, kicked down the front door, and woke the neighbours. He was the kind of alcoholic who hid his cheap beer in the bedside cabinet. If you passed him in the street, you’d have seen a drunk. He had a job, a wife, and five children. I’m one of them.

1. Nobody believes you.

The image of Ireland being a nation of pissheads is largely a stereotype. But it’s true that we do like a drink. Everyone we grew up with drank, and we mostly saw them in situations where drink was plentiful – weddings, funerals, Christmas. Everyone was pissed – including my dad.

He also held down a job. Every morning his alarm would wake us up, followed by the “pssst” of a can being opened (a sound that still freezes my heart, years later). He’d drink in bed, then brush his teeth, get on his bike, and cycle to work. When we bumped into his colleagues, they talked about how funny and friendly he was.

So nobody believed that my dad would be pissed before we turned up at whatever social occasion. And his minty-fresh breath hid the sour, apple-y edge of alcohol. Everyone has one too many and kicks a door in occasionally. Don’t they?

2. You don’t believe yourself.

I don’t blame anybody for not believing us. They didn’t see the worst times. But even seeing isn’t believing. Even when you’re there, cowed under drunken rages, binning cans, helping getting the younger ones ready for school while your dad drinks a beer, part of you doubts it’s really happening. We’d beg our dad to stop drinking and he’d respond by telling us he barely drank – while slurring, with a can in his hand. He’d occasionally say he was an alcoholic and I’d internally hope it was a confession, a turning point. But living with an alcoholic is life within a hall of mirrors, of warped reflections and dead ends. It was no confession – just an excuse for why he could continue drinking. He was an alcoholic, so he drank.

It becomes tediously, painfully normal. You go to school, you see your friends, your dad is drunk, you come home, you have your dinner, your dad is drunk, there’s a massive fight, you go to bed, you lie awake, the staircase creaks, your dad is drunk. Life goes on, and nothing changes. I started to second-guess every emotion I had – every time I cried or felt sad, I told myself I had no reason to cry or be sad. That maybe if I didn’t cry and if I wasn’t sad, he wouldn’t drink. It wasn’t that bad.

3. The best and worst of times are often one and the same.

There were nights my dad would wheel his bike into the house (when he could still cycle) and hanging off the handlebars with a four-pack of beers would be a takeaway for everyone. We’d scatter across the living-room floor watching TV, eating chips, and chatting, just like a normal family. Sometimes he’d cook a steak, avalanche it in pepper, then cut bits off it and give us a piece each with a slice of bread. I cherish the memories of those nights.

Throughout Christmas 2005, he stayed sober and it was wonderful. He was the man we knew was buried beneath the booze – the sarcastic man who had a riposte for everything, the sweet man who leaned against the fireplace with a half smile as you opened your presents (in the years before, he’d have hidden them, with gymnastic squirrelling, in eaves and cupboards you didn’t even notice, let alone could reach), the silly man who always wore the paper hat from the cracker, and the shy man who didn’t want you to take a picture of him wearing it. He’d had days off the drink before, but we hoped this would be the last time, the time it was forever. We had hoped before, but we still hoped.

When it was time for me to leave for my flight, my dad said he’d come and get the taxi with me. I hadn’t had any time alone with him over Christmas so I was happy to have him to myself. We had five minutes before he kissed my cheek hastily, then abruptly got out of the taxi. He crossed the road to the off-licence without turning back. I waved goodbye from the window.

4. It’s not always OK.

That was the last time I saw my dad outside of hospital. He died five months later, on 17 May 2006, at the age of 47. Even now, nearly a decade later, I still think he’s just “somewhere else”. In my dreams he appears in the strangest of places – a caravan on a petrol station forecourt, at the window of a childhood home. Because despite everything, I never believed he would die. In everything I’d ever read or watched (and I hungrily consumed anything I could find about addiction), they were always OK. You’d turn the book over and there they were on the back cover, golden, smiling, and healthy. And I believed, until the end, that’s what would happen to him, too.

But it didn’t.

5. You become jealous of strange things.

Losing any parent is devastating. But I feel a stab of envy for people whose parents die of an illness or of natural causes. Because they have years of memories where the person they loved wasn’t ill, and because they died of something other people can empathise with.

One of the first times I broke down after my dad’s death was while watching an advert about cancer. A bride turns to the camera and says, “I wish my mum was here.” I sobbed and took my tears on to a bus and sobbed there, and then carried them into the work toilets, where I shut the door and sobbed there, too. Because my dad wasn’t going to be at my wedding, or meet my children, or ever again pick up the phone and then pass it to my mum. He wasn’t going to be there, and nobody cared that he wasn’t. There were no adverts about us, no Races for Life, no rattling collection tins. No one fought for him – he was refused a liver transplant, so nobody even tried to save him. There was nothing but condemnation, disdain, and ridicule for people like him, and few shoulders and little sympathy for people like us. People like my dad were heckled on Jeremy Kyle, not held in hushed memorial.

You probably hate me for saying that, and I hate myself for it. No death is easy, no illness is kind. And cancer is brutal, horrific, ugly, and soul-destroying. I hated him, too, for dying in a way that locked us in our grief, that meant we couldn’t even reach out to an awkward shoulder for fear of being blamed, for collapsing under the weight of shame that we couldn’t save the one we loved, with our love.

It’s hard to know what to say when someone dies. It’s hard to write the obituary, to comfort the loved ones, to retell the stories faithfully. In our case, there weren’t any phrases like “he lost his battle” or “he fought hard” – but he did.

6. You develop a strange attitude to alcohol.

You’d think that after seeing alcohol destroy my dad’s life, I’d be a preachy teetotaller. Sometimes I am. When I’m not drinking, I hate being around people who are. I feel panicky when I hear a can open, I feel disgust when someone slurs a gust of booze into my face. I try to avoid hanging out with people I know are heavy drinkers (and I’m pretty good at “spot the alcoholic”).

But sometimes I see people with a beer and they’re laughing and relaxed and happy. And I so violently want to be normal, to be someone other than the girl whose dad died of alcoholism. I’m searching for that ease – of the steak nights, of the takeaways – so I have a beer, hoping to find it. I want to prove that I’m just like everyone else.

But I’m not – I’m my father’s daughter. I find it hard to stop once I’ve started. The ease doesn’t come, because it didn’t come from the beer in the first place. So in the past, I have swung from puritan to pisshead – sometimes within the space of an evening.

7. You’ll live through this.

I have a baby. He’s tiny, beautiful, and hilarious. When I look at him, I can see the ears I inherited from my dad, and our untameable Northern Irish hair. There have been times I’ve held him and wondered how our dad could leave us.

But most of the time, I understand that he didn’t leave us willingly. From the depths of grief it can be hard to see the way out. As the years have passed, I have been able to remember more of the joyful times too. They are the same ones I share with my son – reading a book, chasing each other around around the floor laughing, singing Bowie songs.

I see my son and realise that, just like when I have feelings of sadness that are nothing to do with him, so my dad’s feelings were independent of us all. It was out of our control, and it always was. We didn’t cause it, we couldn’t change it. In his case, it had tragic consequences, but it doesn’t doom us to following the same path.

My siblings are some of the most compassionate people I know. After everything we’ve been through, what we’ve learned is that everyone can struggle – you can have a family, a job, all the trappings of a normal life, and still struggle. That you should try to be kind to everyone, to see them in their entirety and not just as whatever they’re struggling with. To not give into judgements. That happy moments exist, even within the sad times, and that you can be OK, and when you’re not, you are still worth being loved. These are the lessons I want to pass on to my son – that the ease is from inside, and that you are perfect and loveable as you are.

Strangers may have passed my dad and seen a drunk. But he was also the Python devotee and Bowie fanatic who taught us all how to read, bought us our first microscopes, was proud of everything we did, and who photographed the oddest minutes of our lives so now we have a path back to those joyful minutes, to remember and to honour them, and to repeat them.

Thank you for putting into words much of my experience too.

If you’d like to meet like minded people you could always try an Alateen meeting as described here on Newsbeat recently:

Inside an anonymous support group for the children of alcoholics

The NHS is failing people with mental health and substance use problems

This is not the first time I’ve written about mental health and alcohol dual diagnosis and the failure of the NHS to treat appropriately.  You can read my other posts here.

This is what Professor Liz Hughes had to say in The Guardian in December.

dual diagnosisPeople who have mental health along with substance use problems (known as dual diagnosis) have multiple needs, and yet struggle to find services to help them.

Those with complex needs have often experienced a great deal of adversity in their lives, including childhood abuse and deprivation, loss of close family, and poverty. As an adult, having multiple needs brings consequences such as homelessness, unemployment and exploitation, and there is a high risk of poor physical health, suicide, self-harm and of perpetrating violence. Those with dual diagnosis are also unpopular, partly because of society’s entrenched attitudes to substance use problems, which are perceived as a lifestyle choice rather than a health condition deserving of care and treatment.

Dual diagnosis is one of the biggest challenges facing mental health and substance use services, but after 15 years of a variety of initiatives it’s hard to see how things have changed on the frontline. I still hear about the same challenges that were around in the 90s. Mental health services can often exclude people if their problem is perceived to be substance-related and, conversely, substance use services exclude people if their substance use doesn’t fit their criteria.

One of the solutions put forward is to train staff in mental health and substance use with transferable skills and knowledge. Dual diagnosis is the norm, not the exception, and therefore is everyone’s business. Dual diagnosis training has been rolled out, but though it can improve knowledge and skills, it doesn’t always change perceptions and values.

One particular incident stands out from when I was a dual diagnosis worker. It was a Monday, and I arrived at the local psychiatric inpatient unit to see if there were any referrals for me. The nurse in charge greeted me with a “we’ve got one of yours” and a roll of the eyes. A single utterance speaks so much. It demonstrates an absence of compassion – that nurse did not see this person as deserving of care.

My heart sank. I spent a while chatting to “one of mine” and he told me of the trauma, homelessness, desperation, and hopelessness that had led to his suicide attempt at the weekend. He told me that staff at A&E and the mental health team on the ward had treated him with disdain; he did not feel welcome, and so was unlikely to want to stay in treatment and access the help he needed.

One of the consistent messages from service users I have talked to over the years is that they want people to listen, to be with them “where they are at” (as opposed to pushing their agenda on them), not to judge them for their choices, and to have hope. Engaging patients is critical, as we know that loss of contact with services is typically associated with worse outcomes and in some case, increased risk of suicide, self-harm and violence.

Much of the dual diagnosis development in the noughties was supported by the national dual diagnosis programme at the Department of Health. Since the localism agenda of the coalition government, and now the Conservative government, and the cuts to government central budgets, many of the national programmes have disappeared. This is further complicated by the almost complete transfer of substance use services to the third sector and the absence of mental health staff in these new services. Currently dual diagnosis work is based on postcode lottery, and is piecemeal at best.

Testimony must be paid to Progress, a consortium of consultant nurses in dual diagnosis who work locally and as a collective, for free, to keep a resources and information website going, as well as to lobby for better services at government level through the all party parliamentary group for complex needs.

In addition, there are some fantastic examples of where service providers and users work together to improve provision. Leeds is a particular example. An active service user involvement group (the Zip Group) is able to influence the city services at all levels. A vibrant network of users and service staff meet regularly and a funded lead person coordinates the venture.

We face two clear challenges: changing the perceptions of service providers to recognise the complex needs of people with dual diagnosis (which includes a shift in attitudes to substance use), and being able to provide effective services to people with high needs, in a time of unprecedented crisis in mental health provision and loss of mental health expertise within the substance use sector.

The UK dual diagnosis scene is running on nothing but goodwill by a few enthusiastic champions – how long can anything be sustained on this basis? With the increasing need to provide evidence for commissioning, it’s time to harness the data that we have at our finger tips to lobby service providers and commissioners for new roles and new initiatives.

Hear hear Professor Smith hear hear!

Edited to add: 17th Feb 2016

My friend Veronica also had a guest blog post looking at this issue in the US

Most Common Co-Occurring Disorders among Substance Addicts

‘I think my colleague is an alcoholic. What should I do?’

This was covered in The Telegraph back in October and was an excellent response to the reader question about concerns about a work colleague and their drinking.

work dilemmaI’m worried about a colleague and would like your advice. He’s known in the office as a bit of a party boy and often arrives late looking like he’s had a big night out – it’s become a standing joke. But I’m concerned the problem is worse than people think; I recently went on a week-long business trip with him and when he did show up for meetings – he missed most – he either seemed drunk or badly hungover. I’ve been asked by our mutual boss to give feedback on how he performed, but don’t know whether to tell the real story. He’s had one warning already for poor performance and I really don’t want him to lose his job – but I think he needs help. What should I do?

The wider problem

Alcohol and substance abuse in the workplace can create challenges for employers, the employee concerned and their colleagues. There is no ‘one size fits all’ rule for how such issues should be handled.

If a concern is identified, firms can approach it as a disciplinary, health or performance issue (or a combination) with support likely to include specialist counselling, referral to occupational health practitioners, a formal professional intervention – and/or the use of internal disciplinary procedures.

Employees with an alcohol problem have the same rights to support and confidentiality as they would if they had any other medical or psychological condition.

And the problem is huge. The TUC’s Worksmart initiative estimates that up to 17 million working days – between three and five per cent of all absences – are lost each year due to alcohol, while sickness absence due to alcohol is estimated to cost the UK economy over £7.3 billion a year.

In a 2007 survey by the CIPD, Managing Alcohol and Drug Misuse at Work, four out of ten respondents identified the consumption of alcohol as a significant cause or very significant cause of employee absence and lost productivity.

Where to start

You think that your colleague is drinking too much and that it’s impairing his ability to work, based on your recent experience of being on a business trip together.

Your concern for his health and your fears for his job security are absolutely understandable – although it’s important not to make assumptions. Heavy drinkers aren’t necessarily alcoholics.

If your question has been purely about how to act on these concerns, I’d have advised you to have a quiet and tactful talk with your colleague, with the aim of being collaborative rather than confrontational – remembering that if he is in denial then he may quickly become defensive.

However, you’ve been asked explicitly by your boss to comment on his performance – and you need to respond honestly.

Don’t feel guilty

Your fundamental dilemma here arises because you cannot dictate your employer’s response to this issue, and you need to accept that. Once in receipt of new information, your manager will need to take it forward and you will likely be left out of the loop in order to protect your colleague’s right to confidentiality.

While it may feel uncomfortable to ‘hand over’ responsibility, please keep in mind that you cannot and should not deal with this on your own – and shielding your colleague from the consequences of his actions out of kindness may actually do more harm than good.

Remember too, that it’s in your firm’s interests – business as well as human – to offer proactive support. Addiction is a disease, and it can be treated successfully. Ideally, your company should have a clear policy on drug and alcohol use, which would set out the support mechanisms in place for employees. It’s likely to be more cost-effective for them to allow him time off to obtain expert help rather than trying to replace him.

If they ignore the problem, there are likely to be implications on team productivity and morale, as well as your colleague’s health.

Disciplinary action should be a last resort, and indeed a dismissal could be deemed unfair by a court, if an employer makes no attempt to help someone whose work problems are related to alcohol abuse. And if he does eventually lose his job because of this, remember it’s not your fault, and it could be the trigger he needs to seek help.

What to say to your boss

You can try set the tone for your firm’s initial response by emphasising your concern and personal support. Your boss may simply be expecting you to send a quick email summarising what happened on your business trip.

Don’t do this.

Instead, meet face to face, and explain verbally and compassionately why you’re concerned about your colleague. Try not use to judgemental, accusatory or labelling language – at this stage focus on what you observed, rather than expressing any assumptions you’ve made.

If you feel your boss may not handle the information well – he’ll need to be aware of your company’s policy but may not necessarily be – you could bring HR into the conversation too, so they can take it forward together.

For more information about spotting signs of alcohol and substance abuse, and managing these issues in the workplace, check out the following sources:

  1. Drink Aware: Fact checker if you’re concerned about drinking
  2. Health and Safety: A guide for employers on alcohol at work
  3. Alcoholics Anonymous: Is there an alcoholic in the workplace?
  4. British Heart Foundation guide to alcohol at work

Good luck.

I’m no HR manager but that seemed a pretty fair response to the issue.  What do you think?

Care, feel, notice – don’t be afraid

mindful-activity-at-christmas

 

 

 

 

Hokusai says read by Mark Williams [who developed MBCT (Mindfulness Based Cognitive Therapy) and wrote the books ‘Mindfulness: Finding peace in a frantic world’] at the start of the Mindfulness Summit this October.

So much to learn from this poem about presence and being afraid.  Beautiful just beautiful.

When I turned 2 years sober I said: Prim shared an excellent guide to recovery that year one was physical, year two was emotional and year three was spiritual.  I’m still wading through the emotional stuff so we’ll see how I go with the spiritual! 😉

I’m finding with mindfulness and its grounding in Buddhism I am working on my emotional and spiritual growth at the same time.  Win:Win! To help you do the same I’m attaching a gift from Tara Brach I received earlier this month – enjoy 🙂

RAIN-of-Self-Compassion2

I hope you have a wonderfully sober and present Christmas wherever you are in the world.  Stay strong sober warrior 🙂