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Friday, December 30, 2011

Restored to Sanity... or Humanity?

During my visit to Kodiak, I got to experience some of the cultures that make up Native Alaska: Yu'pik, Tlingit, Aleut, Athabaskan and Alutiiq. They all have unique characteristics, and by careful observation the differences were quite observable.

These societies have their own unique ways of looking at the world, not all of which do I necessarily understand or properly appreciate, but then again I've only been the one time. But, I had a discussion with one of the Yu'pik seminarians, Fr. Michael Nicolai, that really got me thinking.

In the course of our conversation, he explained to me how being polite and acting properly is seen in his culture as being a person. When someone is impolite, he stops being a person. He loses his humanity when he fails to act like a human. On the other hand, when someone is respectful and gracious, whether he is Yu'pik or not (the word Yu'pik literally means 'real person'), he is a person.

Therefore, when someone damages his relationships with others by acting improperly, he loses his humanity.  He becomes something else.  It is only when acts properly that he is really who he is meant to be.

We in the West tend to look at humanity more as a biologically inescapable existence.  Sure, we pay lip service to concepts like 'inhumanity' or 'inhumane treatment,' but over all when someone is acting stupid, we are more likely to say that they are 'sick' rather than 'no longer human.'  Therefore, acting inappropriately does not mean someone loses their humanity, but the humanity no longer works. 

In the Big Book of AA, it says in Step 2:

Came to believe that a Power greater than ourselves could restore us to sanity.

AA assumes that humanity is remains throughout the disease, and that the disease of addiction makes one 'insane.'  This implies a dysfunctional humanity.

The Yu'pik definition of humanity is much more 'rigorous,' which will make recovery a challenge for them in this respect: to admit you are an alcoholic and have behaved improperly means you have lost your humanity.  You can see why people would not be willing to admit they were alcoholics, since alcoholism is a form of improper conduct, thus a loss of identity as a human being.

Yet, at the same time, we in the West tend to tolerate a great deal of inappropriate conduct which causes everyone to suffer, all in the name of 'tolerance.'  We even tolerate addicts and often try to excuse their behavior without any real consequences.  After all, the addict really isn't losing his humanity, is he?

The Yu'pik sees the process of addiction as a loss of humanity, and I think this is very important.  The 'sanity' spoken of in Step 2 really is a return to life.  When we are 'medicated' in the disease, we stop living.  The addiction is a means of escape; it is a form of death.

This is a very Christian worldview: the wages of sin is death.  Addiction leads one away from God and into death.  Sin is a loss of our personhood, our humanity.

The loss of this message in the communication of the Gospel has led to many of the problems we now see in the 'Christian world.'  It has been lost in heresy or negligence.  And, it has fed the addictions boom.  No longer are their immediate costs to acting improperly.  We can sin, but the only ramifications happen in the afterlife so they think.  What we do on a daily basis, and the healing and growth we need, is of little concern.  Popular preachers no longer teach about real change, but only the façade of a smile without repentance.

This is not what our Lord Jesus Christ taught.  Christianity means divine change... it means that we are called to put on the 'Real Adam,' who is Christ.  This is why we are called to share His humanity, and thus become real, living humans.

Many people have pushed Christianity into a corner neatly marked 'afterlife' which excuses them to do anything they want to in this life so long as they 'give their hearts to Jesus.'

A Yu'pik, I believe, would be offended by such a notion, and so should we.  When we harm others, we are not acting like humans and we are undermining our humanity.  A sick humanity is no humanity at all.  If we want to be human, we must be a healed human, a complete human, a well human... a real human.

Addiction is a loss of humanity.  It is a state of not-being-human.

Recovery from addiction is a recovery of our humanity, lost in the disease.

I look forward to learning more from all of the seminarians as we set up a remote video lecture series with them to explore the disease of addiction and how they can help their parishioners once they are ordained and return to their communities.  There is much for me to learn.

Thursday, December 29, 2011

Irresponsible Behavior and Addiction

Last night, a friend of mine who is in recovery relayed an incident that happened near him regarding someone who got drunk and committed a crime.  He was rather upset about the incident, and so we went through it until he came to a realization about why he was upset, and so found his own peace with the situation.  However, in the course of that struggle within himself, he said that he thought everyone involved should be sent to AA meetings due to the alcohol factor in the crime.

When we experience or even observe at a distance the healing that occurs within 12 Step groups, it is very easy to assume that sending people by force to meetings will help them recover and end their cycle of self-destructive behaviors.  The truth is, the courts have been doing that for years and we still have prisons loaded with people.  Here's why it does not work.

1) 12 Step groups only work when the participants want to get sober.  In the early days of AA, the group used to vote on a newcomer to see whether he would be allowed to continue with the group or not based on his willingness to follow the program.  While AA later dropped this as it grew, it was an acknowledgement that willingness and self-motivation to get sober were keys to recovery.

It is the same way with the Church: you can Baptize a child and drag him to services, but if he does not want to live with Christ, he will not experience Him.  Now, bringing a child to church has its benefits, since the child will get messages that may later 'ring a bell' and make sense to him (that happens a lot, actually).  And, the same happens for many people that are sent to AA meetings by the courts.

However, it is not a magic recipe, and it usually takes years for these messages to sink in.

2) You don't need to be an addict to engage in self-destructive behavior.  There are plenty of people who act irresponsibly with or without alcohol.  Their thinking is screwed up, and while alcohol may fuel the flames ("Hey, hold my beer and watch this!") many times the fire is already lit.  In 95% of cases, alcohol does not make you do something you don't want to do, it just makes it happen quicker.

Someone with poor thinking needs to be coached on how to think properly and how to become responsible.  Many alcoholics struggle with immaturity outside of addiction (addiction is a contributing factor, since it stunts emotional maturity), but immaturity these days is rampant due to societal expectations.  Thanks to the 'Baby Boomers' we have adults trying desperately not to grow old, who have raise children who don't know how to grow up.

A generation ago, parents raised adults.  Now, they raise teenagers.  And, by definition, teenagers do stupid things.  This phenomenon is a social problem that alcohol aggravates, but it is not the cause.

The 12 Steps can help someone grow up by healing his addiction, but there are lots aspects of maturity that require counseling outside of addictions-specific work.  Counseling can help get irresponsible people to learn responsibility.

It is important to understand the differences so that we don't jump to the conclusion that 12 Steps can cure everything.  Yes, the spiritual lifestyle that the 12 Steps entails leads in the direction of maturity, but the groups are not forms of group therapy.  12 Step groups are about the disease, not necessarily the acquisition of techniques needed for adulthood.  That should go on outside the group, with sponsors, counselors and elders.

The Church must also have a role in providing a clear moral definition adulthood.  Right now, the Church traditionally has relied on culture to do this, but what we are seeing now is that our cultures are dropping the ball.  We see moral and social decay all around us.  Families are disintegrating, moral conduct is becoming rarer, and unhappiness is rampant.  These are all contributing factors to the irresponsible behaviors we often witness.

To preserve our people, the Church must start once again to clearly define good character and ethics as society fails to do so.  I am always sad when I hear about a priest or bishop who appears to be very successful at attracting converts with long speeches about the traditions, but he never mentions the virtues.  These fellows think that virtue is not 'breaking the rules,' but it is more than that.  It is about compassion, kindness, responsibility, emotional self-control, and most of all love.

We must show people in this era how to be loving and moral adults.  This is something that goes way beyond addiction.

Wednesday, December 28, 2011

Some Thoughts About Quitting

People as me quite often: can't someone quit drinking or using without 12 Steps?  The answer is: yes, some people can.

To be very honest, the 12 Steps are a lot of work.  Going to meetings is a lot of work.  Spending hours writing lists of people we are resentful is a lot of work.

Generally speaking, we humans always want to find the easier way.  If you can find it, then take it!  Use the easier way.  There is no shame in it if it leads you to freedom from your obsession.  Just be careful you are not replacing one obsession with another.  That would be the only warning.

However, being a Christian is a lot of work as well.  We pray constantly, we go to confession regularly, we attend services, and serve our brethren.  We are called to live lives of virtue according to the gift of the Holy Spirit within us.  We are warned to repent or face the consequences of our actions.  This is all a great deal of work.

And, all of this is the 'backbone' of what the 12 Steps sets out to do.  A Christian that follows the tradition in an honest manner not only immunizes himself against the 'disease' or loss of will-power to his passions, but he receives the cure for whatever passions may already ail him.

Some people experience a spontaneous gift of sobriety from God, and they never seem to have to go through the long process of the 12 Steps.  However, what comes to them that receive this miraculous healing is not just sobriety, but the same level of repentance and forgiveness of others that the Tradition of the Church and the 12 Steps set out to accomplish in all men.

From Luke 14:16-24  -  

But He said unto him, A certain man made a great supper; and he bade many: and he sent forth his servant at supper time to say to them that were bidden, Come; for all things are now ready.
And they all with one consent began to make excuse. The first said unto him, I have bought a field, and I must needs go out and see it; I pray thee have me excused.
And another said, I have bought five yoke of oxen, and I go to prove them; I pray thee have me excused.
And another said, I have married a wife, and therefore I cannot come.
And the servant came, and told his lord these things. Then the master of the house being angry said to his servant, Go out quickly into the streets and lanes of the city, and bring in hither the poor and maimed and blind and lame.
And the servant said, Lord, what thou didst command is done, and yet there is room.
And the lord said unto the servant, Go out into the highways and hedges, and constrain them to come in, that my house may be filled.
For I say unto you, that none of those men that were bidden shall taste of my supper.

We know this parable to be a portrayal of what happens: God offers us His joy and peace, but we become too busy to come.  The spiritual way is 'too difficult' because we have other things in place of it.  Sobriety is difficult, quitting is difficult, because we have lost our sense of priorities.  This is where the loss of willpower comes into play: our minds have become so lost in the maze of our replacements for God that we can no longer see a way out.

The first thing that comes to mind when someone wants to quit is how he will deal with life without his addiction.  This is not the big daydream about being a millionaire and living on a yacht, but dealing with the family, work, etc.

Stopping an addiction is not as much about 'quitting' as it is about living.

In my own experience, I had know idea how to live as a normal person.  I was afraid of everything.  My own experience required me to sort out the things that I was afraid of and see them with a new light, the Light of God.  Only then was 'quitting' even a possibility.

The Gospel is the 'Good News' because it provides a vision, a hope for life beyond the fruitless cycle of addiction and despair.  Helping addicts is not really about shaming them or forcing them into this program or that, but first and foremost giving them hope through the vision of life without the addiction.

This is an impossible task unless we first are healed.  We cannot shew people into the 'great feast of the Master' unless we ourselves are in attendance.  We cannot give to others what we don't have.  If we don't live the message, then we have no message to share.  All we have are words.  There are lots of those out there.

Our goal ought not to be one of forcing addicts into one treatment scheme or another.  I don't think it is helpful (and a majority of those who are successful in treating addictions agree on this) to even label someone an 'alcoholic' or a 'drug addict' if he hasn't tried to quit a dozen times and failed to stay clean, and then I think it is still not helpful unless he realized the problem and says that he is.  What I think about his problem is less important than what he thinks.  After all, if he does not think he has a problem, he is like the guests that would not come to the feast.  He does not see the feast as a big deal, and what he has is more important.

It is only when we become like the poor people living on the side of road that the feast begins to have meaning.  It is only when we see the feast as a real meal that we need that we will respond to God the way we are supposed to.

That sense of poverty is our 'bottom,' when we start to look for a way out of our condition.  Then we are ready to leave the road and enter the palace.

That's when we really start to quit.

Tuesday, December 27, 2011

What does it mean to be 'addicted?'

In my previous post, I took issue with the proposed DSM-5 definition of addiction which is complex and confusing at best.

The Big Book of AA does not use the term 'addiction,' by rather only directly addresses alcoholism as particular problem and defines alcoholics in Chapter 3:

We alcoholics are men and women who have lost the ability to control our drinking. We know that no real alcoholic ever recovers control. All of us felt at times that we were regaining control, but such intervals-usually brief-were inevitably followed by still less control, which led in time to pitiful and incomprehensible demoralization. We are convinced to a man that alcoholics of our type are in the grip of a progressive illness.
Over any considerable period we get worse, never better.

We are like men who have lost their legs; they never grow new ones. Neither does there appear to be any kind of treatment which will make alcoholics of our kind like other men. We have tried every imaginable remedy. In some instances there has been brief recovery, followed always by a still worse relapse. Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn't done so yet.

If we take alcoholism as a single type of addiction, and apply this definition to the whole of addiction, it looks something like this:

1) An addict is someone who has lost the ability to control his impulse to engage in his addiction.

2) Control over the behavior is not regained even with the realization that the behavior is destructive.

3) Repeated attempts using various methods to stop the addiction have failed, despite sincere efforts.

4) Even when the addict no longer enjoys his addiction, he is drawn back into it when given the means and opportunity.

5) The addict will immediately relapse into compulsive activity if he is allowed engage in the activity again even after a long period of abstinence.

6) When forcibly separated from the addiction, the addict will either obsess about the subject of the addiction or engage in some other obsessive behavior in place of the original manifestation of the addiction.

7) The addictive behavior is linked to specific fears which the addict avoids through the addiction.

As in the previous post, the term 'addict' come from this 'strong interest' aspect of compulsive behavior.  Addiction is an obsession, and it leads to a loss of control over one's behavior.  Thus, the human will becomes compromised.

This is a very serious problem, since the human will is the primary means we rely on to govern our behavior.  Once it is lost, the options to govern behavior are reduced usually to tranquilizers, violence, and other forms of force.  This is why many theorists have contemplated placing criminal activity under the category of addiction.

The Orthodox Church emphasizes the free will of man, and so the question arises as to how a man can lose control over his 'will power.'  Simply put, an addict is someone who makes the decision to hand over control.  An addict engages in the behavior voluntarily in the beginning, but then slowly descends into addiction.  There is a line which is crossed somewhere along the way.  Most of the time, that line is crossed while the person still enjoys the addiction.

This is why addiction is hard to treat: the enjoyment factor covers up the loss of control.  An addict who still enjoys his addiction cannot be convinced otherwise.  It is not until this loss of enjoyment comes that the loss of control becomes evident.  When enjoyment ends and the addict tries to stop, only then does he become aware of the problem.

If we examine this further, we can also see that most of us have the components necessary to become addicts.  We engage in compulsive behaviors all the time.  We get mad even when we don't want to, or we think thoughts we'd rather not.  Is this addiction?

No, it most often is not, but that is because the behavior is not yet entirely destructive. If someone cuts us off in traffic, we don't ram his car off the road when we get mad.  Someone may routinely party too much and get drunk, but if he can abstain before a job interview or decide not to drink without a problem, he's not an addict.

The most powerful human impulse is that of self-preservation, and the loss of this impulse in the face of an obsessive behavior is the clearest sign of addiction.  The addiction has become, at that stage, a type of self-preserving behavior, but not a healthy one.

This is why spirituality is so important: the spiritual path is one where the ultimate means of self-preservation is union with God.  This is why the saints are brave, and that the 12 Steps lead to sobriety.  With faith in God, the instinct to preserve one's self by one's own means diminishes, and the fears the trigger these faulty self-preservative addiction-impulses begin to subside.

The addict ultimately can be defined as a prisoner of fear.

This overcoming of fear is the basis for spiritual growth within the Orthodox Church, and it is also the cure for the addict.

Monday, December 26, 2011

The Meaning of Addiction in Flux (again)

The concept of ‘addict’ is relatively new in its present usage.  Here’s an interesting history of this word, which clearly starts off as a strong interest rather than an uncontrollable obsession:

From a historical perspective as well, we can see that ‘addict’ as a concept was not really present in alcohol usage until the distilling of spirits in the 18th century and the coincidence of industrialization and urbanization:

Addicts have probably always existed, though not in any noticeable number until the last few hundred years.  Then, as the number of alcoholics grew, so did the need for a term or category to assign to this troubled cohort.

The meanings of ‘addict’ and ‘addiction’ have been boiled down to a loss of control over a behavior.  This loss of will-power has frustrated modern medicine, which has exclusively relied on the human will-power to overcome mental illness or its utter sedation.  Hence, we either think our way out of our problems, or anesthetize them into oblivion.

The advent of Alcoholics Anonymous in the mid-20th century meant that addiction could be treated through a spiritually-based program which replicated many of the spiritual traditions of ancient Christianity.  AA was soon recognized by the world of psychological professionals as the only effective treatment they observed results in.

The medical world was beaten back in the 1930’s, when alcoholics and other addicts were often locked up in insane asylums due to their inability to control their drinking.  AA did away with this need, though the medic al profession has not entirely left the field.  Professional counseling, prescribed anti-anxiety medications, and various other services have been continuously offered to recovering (and not-so-recovering) addicts and alcoholics.  Counselors try to use individual and group therapies to help addicts overcome contributing psychological phenomenon (anger management, grief therapy, etc.).

But, in the end, the backbone of treatment still remained with 12 Step groups.  What is fascinating is that the medical world even deferred to AA’s separation of alcohol-abusers (often referred to as ‘heavy drinkers’) versus the person who has lost the ability to control his drinking, the alcoholic.
For AA, the issue is control.

However, the medical profession has never entirely been happy with this definition, in large part because it has had so little success with managing loss-of-control issues, and the results of AA are hard to medically measure.  Now, the medical world is preparing for the new Diagnostics Statistics Manual V (DSM-5), which is preparing to redefine addiction is a more confusing way:

“The DSM-5 will—after a review process already in its closing stages—do away with the long-established distinction between “abuse” and “dependence.” In the DSM-IV, abuse was the harmful or excessive use of a substance, dependence the habitual harmful use of a substance. All addicts were understood to move from abuse to dependence, although not all abusers became dependent (or addicted), so the two conditions were different problems with different diagnostic criteria that demanded a different treatment. Starting with the release of the DSM-5, abuse and dependence will be collapsed into a single diagnosis—“substance use disorder”—specified by 11 “criteria.” You will have to meet only two of these 11 criteria to merit a “moderate” diagnosis—a relatively low threshold that has raised the hackles of some addiction specialists. In the DSM-IV, patients had to meet three criteria out of seven to qualify for a diagnosis of “dependence.”

For addiction to get the official DSM stamp of “disorder” means that entire realms of human behavior will be newly medicalized—or at least newly diagnosed—which will undoubtedly result in more diagnoses, and therefore more business for psychiatrists themselves. In theory, the changes will promote earlier intervention and better outcomes with the national health care system paying out more in the short term but saving in the long run because of fewer serious complications and expensive hospitalizations. Again in theory, former, current and future addicts should benefit, too, but only if they have access to affordable treatment and care….

This change is also based on statistical studies showing that essential difference between abuse and dependence is one of degree rather than kind. The old AA truism that “You can’t be partly alcoholic any more than you can be partly pregnant” will no longer hold. Under the DSM-5 diagnosis for “alcohol use disorder,” you can be “moderately” or “severely” addicted.

Taken together, the introduction of the word addiction with both the increase from seven to 11 of the possible criteria and the decrease from three to two in the required number to meet a diagnosis will have one already-certain result: More of us will be “addicts” than ever before. The implications of this fact, however, are anything but certain.

Thomas Babor, an expert in psychiatric epidemiology at the University of Connecticut and an editor of the international journal Addiction, told The Fix, “If [the  DSM-5] is published as currently proposed, you’re likely to see an explosion or an epidemic of addiction in the United States which is attributable to the fact that instead of three symptoms out of the current seven, you how have to have two symptoms out of eleven. The chances of getting a diagnosis are going to be much greater, which is artificially going to inflate the statistics even further. It could be an embarrassment.”…

So, the changes will allow psychologists and psychiatrists to treat more people for ‘problem drinking’ by choice.  Obviously, those who abuse drugs or alcohol who are not addicted are going to respond much better to treatment than a hard-core addict.  Yes, more people will be categorized, but they will surely point to their numbers and say, “Look at all the people we are helping!”

This new definition is also meant to undercut the centrality of the spiritual experience to recovery.  Sure, there are plenty of people who want recovery without the spiritual element.  That’s been noted.

The problem here is that the medical community and the courts (who turn to the medical community for professional advice in such venues as ‘drug courts’ and ‘substance abuse programs’) still rely on 12 Step groups for their patients.  You will see more and more people being ordered to groups who are able to quit but don’t want to.  More and more unwilling people will be forced to attend meetings to please their probation officers, parole agents, or judges.  What this also means is that 12 Step meetings will become more and more of a ‘turn off’ to more and more people who are ill-prepared.

This also means that meetings will be filled with more and more people who will ‘chill’ the overall honesty that groups need in order to function.  This problem has created an underground community of ‘private’ 12-Step meetings that are held because the regularly posted meetings have become carnivals.

The 12 Steps require willingness, yet more and more unwilling people are going to fall under the expanded definition of the DSM-5.  Whereas the medical community and 12 Steps groups have lived symbiotically for over 70 years, this proposed change might bring all that to a crashing halt.  The main organizations like AA might have to decide to no longer sign ‘court cards,’ thus undermining the highly-flawed attendance system in use.

What’s more, we in the Church are likely to see an increased number of our parishioners falling under this newly-expanded guidelines and wondering if they really have a problem or not.  Clergy will need to prepare themselves now more than ever.

Friday, December 23, 2011

Christmas, Holidays and Drinking

Holidays are a rough time for addicts, mostly because a great of the expectations of the holidays are about relationships, and addicts 'major' in dysfunctional relationships.  We usually spend most of the year ruining our relationships, and holidays act as a reminder of the previous year's (or decade's) blunders. 

Then again, we are also painfully reminded of all those who hurt us.  Many of our injuries that we struggle the most to forgive happen within the confines of the family.

These are contributing factors to the overall problems of addicts often being over-sensitive and thus prone to 'over-feel' certain situations.  This in turn makes the addict feel isolated from others because he picks up on every missed cue or awkward pause.  The overreaction to these hiccups in socializing lead to further missteps and greater awkwardness.

Humility helps overcome the embarrassment of social awkwardness and isolation.  When we accept that things will always feel weird and that we will always appear out-of-place, then we can be free enough to be ourselves.  Once we start 'acting naturally,' a whole lot of problems pass away.

If you know an addict, this is a good time to reach out to him or her and let them know that you look forward to being with them.  Your own expression of acceptance can go a long way with someone who struggles to feel 'part of.'

If you are the addict, then be on guard against those feelings of isolation.  Remember that how you feel and how things really are can be (and usually are) two entirely different things.  Go to a meeting, spend time with others in recovery, and remember that the real reason for this season is to give thanks to God rather than having clumbsy conversations with relatives.

Stay focussed on God.  After all, He put the 'holy' in holidays.

Thursday, December 22, 2011

Starting with the Parish or the Diocese?

In America, largely due to the isolation of our parishes from one another and influence of Protestantism, our communities tend to be 'parish-centric.'  Our view of the Church really involves our view of the parish, and the rest of the Church is seen as a distant, but perhaps influential, extension of the parish.  Priests are expected to 'run' their parishes and provide for all of the needs of the community, supported at a distance by the bishop and occasional extras from the diocese/eparchy/jurisdiction.

Priests are expected to effectively carry out teaching, preaching, spiritual counseling, elementary marital and pre-marital counseling, youth counseling & 'youth ministry' along with handling the occasional parishioner with an addictions issue.  I say 'occasional' because most addicts will hide their addictions from their priest at all cost or will leave the community when it becomes obvious.  Most of our communities do not do well with encouraging repentance, mostly because of the shame-based cultures of origin.  As a single influence on the group, the priest is not only over-stretched as far as talents necessary, but also numerically outnumbered when it comes to changing the shame-paradigm to an ascetical one that encourages repentance rather than shame and indelible stigma.

Being outnumbered, the priest is simply not going to do all of his jobs effectively. That's why the traditional model of the Church as always been the eparchy (we here, for some reason, continue to call these larger units 'dioceses' though this is not what they are).  Within our dioceses/eparchies, the bishop presides over a number of parishes from which members can easily pass without having priests complain that Father X is 'sheep stealing' and parish councils are wondering if Mr. Y is going ot fill out his pledge card here or somewhere else.

Such a system also allows for the creation of larger ministries.  Addictions counseling by a dedicated, or at least talented, person can be provided for all of the parishes.  Father X does not have to struggle with all these various forms of counseling, and he can refer people to specialists within the eparchy/diocese for help when he discerns the problem is beyond his abilities to handle on his own.

This is how the Romanian Orthodox Church is handling addictions: all the priests are starting to receive education in addictions, but treatment is being handled by the eparchies and metropolitanates.  In rural communities, the priests are being encouraged to start AA and Al-Anon groups, but only  'get the ball rolling' and then let the recovering addicts self-manage their meetings and provide their own sponsorship.  Of course, the Church is providing the materials, guidance, and encouragement.

What the Romanian Orthodox Church has discovered is that the Orthodox Faith is a powerful medicine for healing addicts, but they must begin with educating their communities and removing the stigma from addiction so that addicts stay in the Church and get help.  They are making good progress.

We here in America have the advantage of being surrounded by 12 Step groups, who often help our parishioners even before the priest even knows about the problem.  But, what this has done is allowed our parishes to become isolated from the problem of addiction, expecting someone else to handle it.  This is a false idea: addiction is a spiritual disease, so where better than in the Church?  Why are we not seeking to help addicts, given the gift of the Tradition we have received?

Again, this has a great deal to do with the expectations of our communities that our parishes are 'ours.'  We do not see beyond our few families.  In order for us to better treat addicts, and offer addicts the Gospel and the healing of our Lord Jesus Christ, our bishops really need to step in and start educating and providing local treatment options for both Orthodox and non-Orthodox.  We must evangelize and re-evangelize.

Such a massive change in expectations must come down from the hierarchy.  Priests and parishes cannot do this on their own.  While a few isolated parishes might 'get it' and offer help to addicts, a vast majority don't know how.  They might even not know that it is possible.

Until this happens, it is important for Orthodox Christians to prepare for this change:

1) Learn about addictions by reading about the 12 Steps (Fr. Meletios' book is a good starter: )

2) Talk to your priest and community about what your parish can do to open itself to helping addicts.  You may find that by opening the topic you have more than a couple of addicts in your parish that have been afraid of being 'found out' and shamed.

3) Open your parish to hosting a 12 Step recovery group such as AA, OA, or NA.

4) Ask your bishop to consider guiding all of his parishes towards a new understanding of addiction as a spiritual disease and bringing in recovering addicts as a type of evangelization.

Wednesday, December 21, 2011

Dostoevsky's Recovery

A while back, the Mystagogy blog featured an article about Fyodor Dostoevsky's recovery from a severe gambling addiction which devoured his fortunes and his relationships:

Dostoevsky's description of his gambling addiction was summarized in his essay, The Gambler.  To this day, it is studied by experts as one of the most accurate portrayals of what this disease feels like for the addict:

As you can see, the various theories have been postulated why a gambler will gamble, either to win or to lose, either symbolically or literally.  But, if you read what's really going on in the story, the gambler is addicted to the 'experience' of gambling.

Dostoevsky's story is powerful because the reader is drawn into the story of the experience.  Addicts are drawn to their addictions not necessarily because of the outcomes (which usually become negative once the will is compromised and the full disease has set in), but rather because the addiction provides a complete escape from all the problems of the addict.

A substance abuser can relates to Dostoevsky's experience because of the great focus the act of the addiction brings: no longer does his mind swirl with his problems and the likely outcomes of his actions, but he becomes enraptured in the moment.  The addict lives for the moment, and his focus becomes very narrow.  Thus, he experiences the 'great escape.'

But, what about the recovery?  Freud, who studied Dostoevsky, really never spoke of it when analyzing his writings.  Then again, Dostoevsky never clearly wrote about it.

From the Prof. David Starr article:

We noted near the beginning that Joseph Frank found it remarkable that Freud, having devoted a substantial article to arguing that Dostoevsky’s vices and particularly his gambling were results of perverse passions induced by childhood trauma, never mentions the recovery from gambling addiction. Though Freud saw the deficient fathers and parricides in his novels as evidence of his thesis, the very novel in progress at the time of Dostoevsky’s deliverance from addiction was Devils, in which a pathetic father, Stepan, found repentance; and a spiritual father, Tikhon, reveals to Stavrogin that he must find his own repentance for his terrible sin against the young girl who committed suicide. Dostoevsky was just finishing the first part of the novel, when he left the gambling tables for the last time. I believe his final effectual repentance caused or was affected by realizing his responsibility for his life and forgiving his father. In The Adolescent the father of Arkady’s flesh is incipiently reformed by illness, and by novel’s end it is possible he may shoulder responsibility to marry Arkady’s mother. We have no certainty Versilov will keep his promise, but we have spiritually authoritative testimony that it is possible. Tikhon, Makar and Zosima in these last great novels attest to a spiritual presence on earth and within the characters’ lives of the Heavenly Father bearing the love of Christ and assisting in the transformation of the novels’ protagonists.

Freud did not think such a spiritual cure realistic, but Dostoevsky proves that it is possible. We have mentioned the words of Father Zosima to Father Fyodor: "Stop lying, most especially to yourself, for that destroys receptivity to truth, which yields contempt, from which inability to love must follow." On Zosima’s account to adhere to truth can yield respect, love and forgiveness. The same realization freed Dostoevsky’s from gambling and made his love for Anna and his children effectual. Did it also enable him to forgive his father? In Crime and Punishment and The Idiot the protagonists’ fathers are simply missing, but in Devils, The Adolescent, and Brothers Karamazov we have poor excuses for fathers who are either repentant or capable of repentance. Dostoevsky had been such a father, and in 1871 finally ceased to resemble his most pathetic characters in this respect. He repented and it seems at the same time learned how to forgive fathers. If Freud is right about any of the elements of his pathology, then its cure must indicate a reversal or removal of the cause.

Even Fyodor Pavlovich has a vestigial soul, and we learn to see him through the forgiving eyes of Alyosha and in the authoritative light of Zosima’s admonitions. We understand Dmitri’s anger and Ivan’s contempt and even find Smerdyakov’s pathetic hatred understandable. Even Dmitri and Ivan finally begin to lose their destructive passions. Is this realistic? It may not be common, but it is real, and Dostoevsky is our witness. There may be a particle of truth in Freud’s aeteological speculation, but there is surely no room in his psychoanalytic theory for Dostoevsky’s kind of therapy; for its basis is excluded from Freud’s supposed causal nexus. Without freedom, how can there be healing? Though Freud knows that the patient must actively participate in his cure, human activity is never distinguished from passion. Freud confines himself to the passions and assigns agency only to physical instinct and its manifestations, yet the mystery Freud recognizes in the creative process of Dostoevsky’s art must refer itself to a greater Mystery, as Dostoevsky finally understood.

He says of Pushkin, that his poetic genius was at most assisted by external stimuli, “...calling forth in him what lay hidden in the depth of his soul, the organic unity of the internal wholeness of which encompassed all the principles of his creative work.” The source of this wholeness is Christ, in whose image we were created, and by whose Incarnation that image is renewed among us and, especially those enlightened by the Gospel and the mystery of the Church. Man without Christ subverts his nature, pretending to be god and making man — gods of or for himself — i.e., persons or the state. Christ the God-man corrects this, enabling men to become god-bearers in the Spirit of loving union with each other, in Him. Such sources of literary activity surely apply to Dostoevsky himself at least as much as Pushkin, of whom he spoke them in the 1880 address and in its defense later the same year — even more, since Dostoevsky’s spiritual struggle seems more evident.

That he understood himself far better than Freud did is attested by the fact that he was cured of gambling and many other ills not by himself, as Frank implies, but by Christ, as Dostoevsky himself understood through repentance and regeneration. That he knew human nature deeply appears in his ability to recognize, as few moderns do, that the generic physiological and socio—economic causes that limit us interact with and are affected by the personal will. Such freedom is not incompatible with causality, since environmental causes affect us differently as we voluntarily change how we relate to them. In the image of the Holy Trinity, man is one in being while existing in distinctly embodied persons, and because human being is prior in the order of creation to other causes, we need not choose between individual moralism and amoral passivity before material causes. Dostoevsky articulates why he subscribes to neither:

"…[T]he people are aware... that they themselves are guilty in common with every criminal. Still, blaming themselves, they do not prove thereby that they believe in 'environment'; on the contrary they believe that environment is wholly dependent on ... their uninterrupted repentance and self-betterment. Energy, work and struggle — these are the things which reform environment. By work and struggle alone, independence and the sentiment of self-respect are being achieved... That is what the Russian people, by a strong feeling, are tacitly conceiving in their concealed idea of the misfortune of the criminal."

He learned from the Orthodox people that co-suffering love is the Way of the God-man. Having embraced the word of Christ and taken His yoke upon them, by His Spirit men have access to His energy. Dostoevsky, having found that access, found empirical theology, and that Truth gave him freedom.

If anyone understood Dostoevsky better than he understood himself, it may have been the authentic healer of souls from whom he sought help after the death of his son Alexei. It seems fitting to give the last word to a real elder who knew him, and on whom he in part modeled his Elder Zosima. Starets Amvrosy of Optina commented after his visit to his hermitage near Kaluga in 1878, “This is a man who repents.”

Dostoevsky found hope in God that led him to return to reality and thus recovery.  Addictions are primarily the escape from reality.  In his writings, Dostoevsky tried to show that man can exist in even the harshest realities and yet still find God there.  Thus, there is hope even for the worst kinds of guilt and remorse.

Freud could not understand Dostoevsky's recovery because he could not grasp the belief that God even exists:

If one wishes to form a true estimate of the full grandeur of religion, one must keep in mind what it undertakes to do for men. It gives them information about the source and origin of the universe, it assures them of protection and final happiness amid the changing vicissitudes of life, and it guides their thoughts and motions by means of precepts which are backed by the whole force of its authority.  - New Introductory Lectures on Psychoanalysis

Religion is an illusion and it derives its strength from the fact that it falls in with our instinctual desires. -  New Introductory Lectures on Psychoanalysis

Devout believers are safeguarded in a high degree against the risk of certain neurotic illnesses; their acceptance of the universal neurosis spares them the task of constructing a personal one. - The Future of an Illusion

At bottom God is nothing more than an exalted father. - Totem and Taboo

Yet, Freud found no way through his psychoanalysis to achieve what 12 Step groups have been able to accomplish with God.  Freud is now more of an influential historical character rather than a genuine source of knowledge about the human condition.

The truth is that man is far healthier knowing a loving God than he is dwelling in his own ego.  Dostoevsky realized this after seeking help from the Church, and eventually was freed from his disease.  What Freud called a 'neurosis' is actually the cure.

Tuesday, December 20, 2011

The Four Supports for Recovery

The reason that I took the time to address clergy codependency is that the Church serves as one of the four means of support an addict has for beginning and maintaining sobriety.  Codependency, the condition by which a person derives their own sense of well-being from another person, turns what should be a source of strength for recovery into a well from which the disease can draw the waters of destruction.

Priests are usually the ones with whom the addict will deal when it comes to the Church, and so we must examine how priests are formed and how they see themselves in order to see what the Church's role is in recovery.  It is important to stress, however, that the Church is more than the priest, but very often the priest is the means by which the average person interacts with the Church.

Let's return to the matter at hand, the Four Supports.  I'll go through them briefly:

1) The Recovery Group- the 12-Step group is usually at the center of an addicts recovery, where he finds other co-strugglers with whom to share experience, strength, and hope.  Addicts rarely find their way on their own.  There are a few cases where real miracles occur and someone is instantaneously cured of an addiction, but these are far more the exception than the rule.

Now, recovery groups are getting a bum rap these days, but I believe this has mostly to do with the 'over-prescription' of AA meetings by courts and the over-use of the term 'addict' when the drinking/using is still very much a choice.  Just because someone is drinking in a reckless manner or even using hard-core drugs, even to the point of physical dependency, he is not necessarily an addict.  addiction is a total loss of control, which only people who have experienced can fully understand.  This is why the group is so important: it can speak directly to the addict in a way that cannot easily be ignored.  It say, 'If we can, then so can you.'  No one else has the credibility to say that.

2) The Family- while Americans are not really family-oriented people (we are the descendants of people who emigrated away from extended family, and this does leave a mark as we see Americans move around much more than is seen in other cultures), what remains of the family is important.

Addicts often first turn to family when looking for help in maintaining their disease, and the emotional blackmail doled out by the addict usually effects the family in a negative way.  However, if the family is healed, or has maintained a proper view of the disease, then its health can be a source of inspiration and support for the recovering addict.

3) The Church- the foundation of recovery is a spiritual one, and the Church defines spirituality outside of the ambiguous 'anonymity' of 12-Steps.  The anonymity and escape from religious terminology is important, either because someone's addiction has been exacerbated by heresy (yes, heresy makes addictions worse, a topic I promise to explore later) or by a false sense of understanding what is really misunderstood.

Plenty of Orthodox misunderstand God.  They know the right words, but have applied the wrong meaning.  Therefore, the Church must make a particular effort not only to teach, but to continue to help people explore the Tradition and get the 'real meaning.'

There are quite a few addicts who get sober without the Church, but those who have later converted (and I speak from experience) will tell you that the Church has deepened their spiritual experience and made it full in such a way that the 12-Steps does not describe.  In fact, the original book Alcoholics Anonymous assumed that there was a Church and that people should go to it to complete their spiritual search, but for many in the US and the West, the problem has been that the churches they have attended held to heretical teachings that undermined the spiritual growth of people in general and addicts in particular.

Only the True Church can truly help the addict.

4) Profession Counseling- the last category is counseling, which was the only means of 'treatment' in the West prior to AA and the development of the 12 Steps.  It has also had some of the worse results, but mostly because it cannot, by nature of our modern construct of counseling, address the spiritual nature of the disease.  This is why medical treatment alone rarely has a positive outcome.

This has largely to do with the core of counseling, which is the ego.  Now, the ego does need to be 'cured' in that it must have a right understanding of itself in terms of what has happened to it and what it can do.  Counseling is good at helping the addict deal with contributing factors that led to addiction.  The problem is when a counselor assumes that fixing the ego is all that is necessary.

What modern counseling does not quite get is that the real problem of human existence are the kinds of fears we experience which only faith in God can cure.  These are the 'ontological fears' that terrorize us and cause us to turn to our selves for hope and confidence.  This is where pride kicks in and addiction gets its start.

Quite a few addicts get sober without setting foot in a counselor's office, but this does not mean that counseling is not important.  It is, particularly if the life experience of the addict has been particularly traumatic.

Conclusion- an addict with these four supports while working the Steps will more often than not find sobriety and recovery.  The removal of any one of these supports drastically reduces the chances of being healed.  When trying to help an addict, it is important to look at the person's opportunity to recover in terms of these four supports.

Monday, December 19, 2011

Codependency and Cultish Priests

In the comments section, Fr. Peter wrote this insightful response to the post on codependency:

I think the idea that people like/want to be needed plays into co-dependence. I quite surprised someone when I said that I do not want to be needed. Yes, I like to help, but to be needed in a dependent sense, no thank you. To me this parallels something we talked about at the seminary about the role of the spiritual father in his relationship with a spiritual child. We talked about that role as being not one in which the spiritual child becomes dependent on the spiritual father, but one where the spiritual father guides the spiritual child towards spiritual maturity - not self-sufficiency, since that is impossible. I'm not sure exactly where I am going with this comment and I apologize for that. The parallel above just jumped out at me and made me think a little about the potential similarities between someone helping with addictions and a spiritual father.

Fr. Peter is describing what happens when codependency sneaks into the priesthood, and priests begin to use their ministry as a means of bolstering their own sense of self-worth rather than helping people become more Christ-like.  Some clergy set out to make their people dependent on them, just like a codependent thrives on the addict 'needing' his or her help.

In this regard, Fr. Peter is not alone in his observation.  Consider Monk Moses the Athonite's similar stand (thanks to John Sanidopoulos' outstanding blog):

Some immature, ambitious, inexperienced, totally tasteless of basic spirituality clergy appear as elders, thus satisfying desires, passions and fantasies.

This phenomenon is worthy of carefulness and worthy of tears.

Young people who have never had obedience, seek absolute obedience from their spiritual children.

They themselves live a shallow spiritual life and enforce rules impossible for beginners.

They are strict with others and very lenient on themselves.

They want to make their parishes into monasteries to compel followers to a heavy typikon, only to be admired as traditional and strict.

They want to create fanatic followers, frozen and servile.

They want to afflict souls and ultimately delay the actual spiritual ascent, afflicting them with their occupation with unnecessary and tedious details.

Leaders of the Russian Orthodox Church have already made similar statements concerning the problem of the 'neo-staretz' phenomenon and how young priests try to act like holy elders.  It happens not just in Greece and Russia, but here in the US.  It is a phenomenon that appears in all quarters of the Church.

Very simply, most of this cultish behavior comes from the priest's own insecurity with himself and how to 'manage' the free-will of others.  He often wants 'control' because it makes his life easier.  But, this type of dependency that his control creates also is a form of codependency in himself.  He needs to be needed in order to feel value and worth.  He derives his sense of security not from God, but from the crowd of people around him clamoring for his attention.

He will not admit it, but he at once needs and hates these people.  He treats them roughly and kindly in alternative 'flips,' drawing them in with kindness and then applying strictness in order to 'train' them into obedience to his need to be in control.  Of course, this only works with 'needy people,' but there are plenty of them out there.

And, just like the addict, the cultish priest, once secure in his disease, will often lash out at the people.  This 'strictness' really isn't strictness in the sense of how this usually works in the Church.  Strictness is a tool used occasionally to help the other perfect his will with God's help.  The cult-priest uses strictness to maintain control and suppress the free-will of others.

However, he also uses strictness as an expression of hatred for himself.  He hates the people because they remind him of his dependence.  These strict priests often have no inner peace, though they might have lots of charm.  They are 'bothered' by what other people do.  The sins and rebellion of others 'pain' them, which is initially represented as 'compassion' but usually degenerates into criticism.  Genuine compassion lacks this critical component.

Addicts behave the same way, at once hating their disease and yet needing the comfort it brings.  This is why codependents and addicts have a mutual relationship: one is addicted to a substance, the other is addicted to people (usually the addict or some other dysfunctional person).

Like the man in the picture below riding the shark, the codependent priest is afraid to let go of his 'control' (i.e. his grip) on the crowd.  Therefore, he becomes a slave to it.  What appears at first to be thrilling (isn't power said to be an aphrodisiac?) is now a reminder of his weakness: he can't get off the ride.  He is stuck, a prisoner to his 'parish' which he need and yet resents.

He may try to escape for brief periods of 'rest' or 'pilgrimage,' but in the end his abstinence is followed by more self-indulgence.  It is a dangerous cycle, where the priest becomes the sickest of all the people in the parish.

Fr. Peter's comment is an excellent insight into the spiritual disease of codependency.  As we move along, we can look more into the cure: genuine faith.  

Sunday, December 18, 2011

Sometimes recovery feels like...

Yes, this is how an addict often feels...

Sometimes the addict feels like he is in mortal danger if he lets go of his disease.  We would be lying to say that's not true.

The Orthodox Christian knows he must die to himself and his fallen self in order to receive the new life in Christ.  Sin leads to death, and addiction likewise leads to death.  But, it is the death of the fallen self, the part that must be surrendered.

Recovery starts when we let go of the shark.  Will it bite?  Yes, it must because that's what it does.  But, the death of addicted self leads to the freedom of the recovering self.  So long as we hold onto the shark, the shark is in control.  But, once we die to the shark, then we realize we can only die once.  Once we die to the disease and surrender, then we can start enjoying freedom from the shark's path.

By dying, we live.