What about a No-God approach?

Since alcoholism treatment began, a purely scientific-medical approach has been at the forefront of efforts to sober people up.  AA and the 12 Steps arose with the failure of psychological help alone to save the addict from his disease.

The latest attempt is called ‘Smart Recovery,’

http://www.guardian.co.uk/society/2010/mar/10/alcoholism-treatment-smart-recovery-programme?INTCMP=SRCH

Note that part of the article was retracted, having misrepresented his criticism of AA:

http://www.guardian.co.uk/theguardian/2010/mar/18/corrections-clarifications?INTCMP=SRCH

SR does have a manual, which gives you some idea of how it is organized:

http://www.smartrecovery.org/resources/library/For_Family_Volunteers_Professionals/SR-FQSM.pdf

It is primarily based on Cognitive Behavioral Therapy, which appears to be fairly effective in the treatment of Obsessive Compulsive Disorders.  CBT has helped a lot of people.  But, it is the latest trend, and so we need to see where psychology goes over the next 30 years to see how it pans out compared to other systems.

‘Smart Recovery’ grew out of ‘Rational Recovery,’ another CBT-based approach that officially disbanded.  Rational Recovery started because some addicts refused to accept the concept of a Higher Power, as ambiguous as the term appears.  It was too much for them, and so a new approach was developed to avoid reliance on anything other than the self.

From Wikipedia:

http://en.wikipedia.org/wiki/Rational_Recovery#Meetings_Cancelled

“Rational Recovery claims that “AVRT has made recovery groups obsolete.” In 1998, Rational Recovery announced, “The Recovery Group Movement is Over!...Beginning January 1, 1999, all addiction recovery group meetings for Rational Recovery in the United States, Canada, and abroad are hereby canceled and will not be rescheduled ever again, it's just a waste of time and is completely unproductive.” Despite those remarks, there are still some groups in existence today, although the numbers are dwindling.

“In a 1993 research study led by Marc Galanter, former president of both the American Society of Addiction Medicine and the American Association of Addiction Psychiatry, attempted to measure the impact of Rational Recovery on members. The research found that “Rational Recovery succeeded in engaging substance abusers and promoting abstinence among many of them while presenting a cognitive orientation that is different from the spiritual one of AA. Its utility in substance abuse treatment warrants further assessment. The results of the impact on this type of recovery are too few to make an educational assumption” This research was conducted before Rational Recovery disbanded their meetings in favor of self-recovery treatment. SMART Recovery split from Rational Recovery just after this research and continues to offer these same groups.”

Disbanding RR prevented field studies of its success rates, and so we have little clinical evidence of its effectiveness.

The problem with this approach is that it still relies on the broken will of the addict to heal himself.  While the 12 Steps require willingness, it is not self-will-powered system.  The self-will is considered broken, and so it cannot be used.  The addict relies on God, through the sponsor and group, so sort out reality from fiction and ‘return to sanity.’

Rational/Smart Recovery does not assume a broken will, but a dysfunctional one which is still intact enough to make decisions on its own if realigned and fed the proper data.

So, what do we make of this?  Well, AA itself boasts only of its results when all other methods have been tried.  Ration Recovery or Smart Recovery might work for some, in which case we ought to wish them well.  There simply is no argument: if you can will yourself to stop drinking, then do so!

The 12 Steps are for those who have had no success with any other method.  It is for those who are beyond the kind of help that SR offers.  Some people can have a profound change of heart that needs no further work.  The addiction, or the appearance of an addiction, just stops.

There are also people who abuse substances for a certain period of time, appearing to be addicts, but then stop the abuse and regain responsible behavior.  Again, if you can stop abusing and regain control, then do so.  You don’t need God’s help, steps, sponsors, groups or anything else.  Just do it.

Like the woman with an issue of blood (Matthew 9:19-21, Mark 5:24-26, & Luke 8:42-45), once you have tried all the doctors, the only option left is God.  If you can find help elsewhere, then find it.

The amount of work, the humiliation, and the pain of the 12-Step process almost makes it too much for people who can fathom some other alternative way of getting sober.  We wish them well, and will always welcome them if they decide to try what we do.

For over 70 years, the 12 Steps have had a proven record of helping the hopeless alcoholics become healthy and happy members of society.  Though no program can boast a 100% success rate, groups like AA and NA have higher success rates than any counselling program alone has been able to achieve.

In like manner, the Orthodox Church has the longest track record of enduring persecution for Christ's sake while producing saints and healing the souls and bodies of those who repent.  The 12 Steps ultimately lead to the realization of the Church as the destination of the addict, and I believe this is the right time to begin to proclaim this reality out in the open.

There are many people who will always reject God.  We do not hate them.  We ought to, instead, pray for them.

The St. Dimitrie Program

I mentioned Floyd in previous posts, who has become the 'godfather' (in the not-kneecap-breaking sense of the word!) of Orthodox recovery programs.  Here is a link to his OCMC page:

http://www.ocmc.org/missionaries/missionary_profile.aspx?MissionaryId=4

Floyd is responsible for getting the Church of Romania to recognize the effectiveness of the 12-Step program for the treatment of alcoholism, and now his materials are being integrated into the seminary curriculum in Romania's schools and he has been tasked with training thousands of Romanian priests in how to establish AA groups in their villages and towns.

The Romanian Church is also working to set up in- and out-patient treatment programs which use the Minnesota Model for clinical treatment.  Gradually, Patriarch Daniel of Bucharest (who has supported Floyd's work from the beginning when he was Metropolitan of Iasi) is getting the entire Church to embrace Floyd's work.

In 2008, I spent a few weeks with Floyd and we did trainings in three cities.  It was really amazing to see the openness that the clergy had towards what we were talking about once we got past the terminological problems.  American recovery programs have a whole bunch of terms that Romanians either don't understand or misunderstand, and so we first had to unpack the whole 12 Step model in Orthodox terms.

As this blog develops, I will be posting Floyd's work on this topic.  Floyd has already written a book for the Romanian Church which has been officially adopted by the BOR as a definite source on addictions recovery.

Alcoholism versus Other Addictions

I’ve gotten some interesting feedback which I would like to share, some of which I will be integrating into the blog very soon.

One of the things I have noticed is that as alcohol addiction in the US has fallen into disfavor, other diseases have cropped up.  Think about it: we no longer see public drunkenness in the US the way you see in other parts of the world. 

These are just a few examples I pulled from the BBC having to do with Anglophonic nations and their alcohol-abuse woes:

http://news.bbc.co.uk/2/hi/asia-pacific/8407309.stm

http://www.bbc.co.uk/news/uk-england-york-north-yorkshire-15783807

http://news.bbc.co.uk/2/hi/asia-pacific/6708533.stm

http://www.bbc.co.uk/news/uk-scotland-scotland-politics-15525950

http://news.bbc.co.uk/today/hi/today/newsid_9619000/9619577.stm

Sure, the US has its places where being stumble-in-the-streets drunk is OK (colleges for instance), but unless you at Marti Gras in New Orleans, the average town fair isn’t going to result in dozens of passed-out citizens piled up outside the venue.  In other places in the world, that’s just the beginning of the evening.

When I lived in the UK, it was very common to encounter employees in shops well-early in the morning stinking of a fresh drink to nip off the hangover, whereas in most places in America showing up with the same odor will likely get you fired in short order.

This does not mean that the US has gotten any healthier, however.  The crack epidemic in the 1980s changed attitudes to public intoxication, but it did not do much to address the underlying dysfunction of the average citizen.  With a rise in technology, more Americans are running into other, less obvious addictions.  Computers have become a major problem:

http://www.bbc.co.uk/news/health-15720178

Yes, video game addiction can develop and affect the brain in a way close to other diseases.

Pornography, made easily available through the ‘clean’ internet rather than embarrassing shops, is spreading:

http://news.bbc.co.uk/2/hi/uk_news/7180401.stm

Once these addictions set in and the brain begins to change, it takes a lot of painful work to heal the mind and body of the addict and bring about sobriety and freedom from the addiction.  It is just as much work as repairing the stumble-in-the-streets drunk.  The difficulty is that the public drunk is obvious, but the gaming addict, the gambler, or the sex addict can hide much more easily.

This makes it much more challenging to confront the addict.  A substance-abuser can be ‘caught’ intoxicated and not snap out of it instantly, unlike the other addictions which do not have long-lasting effects.  It takes hours to sober up, but a problemed gambler can step away from his online poker addiction and be ready to 'function' in a matter of moments.  He may go into debt and bankruptcy, but those problems are often not associated with a gambling addiction, unlike the alcoholic who's cirrhosis is hard to explain as being anything other than a symptom of his disease.

The gamer may stay locked away from real relationships for hours, even days, but remain employed and thus ‘respectable.’  We occasionally crack jokes about the game nerd who lives in his parents’ house, isn’t married and spends hours on the computer.  Is this addiction, or just a choice?

What about the porn addict, who will generally contend that his habit hurts no-one, especially if the ‘stars’ of his chosen media are well-paid and looked after with his money?

We know that banning porn or video games will only drive it underground.  Prohibition of easily-produced items never works (you can more easily ban enriched uranium or heroin because they are in limited quantities produced only in certain places, whereas alcohol or a clumsily produced video can be made in anyone’s bathroom with a few simple ingredients).  But, what are the costs?

How much of America’s addictive cravings have simply moved from alcohol to something else?  While we may pat ourselves on the back to think that we do not have the public intoxication problems of, let’s say, Romania, the question remains as a society whether we are all that much better off?

My opinion is that we are just as sick, but our addictions are simply less obvious and thus easier to rationalize.  The Ukraine may have an extremely high level of alcoholism, but if you compile the unhealthy addictions of Americans, there will only be a small difference in terms of ratios.

Alcoholism treatment is a good start, but it is also the easiest because its symptoms are harder to hide: intoxication, odor, organ failure, etc.  As a Church, we need to look beyond alcoholism to all the various addictions, and beyond them as well to get at the root of the problem.

Alaskan Adventure

Starting this coming Friday, you probably won’t see daily posts from me because I will be catching planes, trains, and automobiles to get from LAX to Kodiak, Alaska.  After spending the weekend with them (I’m looking forward to my first Divine Liturgy in Alaska!), Monday will begin the lecture series I’ve already mentioned.

Eventually, I hope to be able to post all of the lectures either as podcasts or YouTube videos.  When that happens, I will post links here for those who are interested both in the theology of recovery and the practical aspects of recovery in the Church.

My sense is that addiction in Alaska has its peculiarities, but shares not only the basic human components of addiction in general, but many of the modern problems we are all facing: loneliness, pace of life issues, lack of certainty, broken relationships, etc.  Alaska’s remoteness does not make it immune to the problems of the rest of the nation, and even the world.  There is too much TV and other technologies piping in bad messages, which infect all of our hearts.

So, the work in Alaska has national and international implications: the development of some future programs in Alaska may lead to further programs that can be modified to fit in other cultures and societies.  This topic, culture, is a really big one.

From “The Basis of the Social Concept”

Below is an excerpt from the Moscow Patriarchate’s approach model for social work the 21^st century.  It is quite thorough and well thought-out, and we are all interested to see how this plays out in implementation.

The goal of “prevention and rehabilitation” within an Orthodox context is what I have been working on for the last few years, though there are others who have done far more and have devoted much more time to the matter: Floyd Frantz, Fr. Iulian Negru and many others.  All of us desire to the see that national Orthodox Churches cooperate in the creation and implementation of locally-based and –directed efforts to heal people from the disease of addiction.

My experience so far is that our hierarchs understand there is a problem and want to do something, but are usually unable to conceive of an approach that they have confidence in.  Many have tried to deal with alcoholics using the standard methods (requests, pleadings, demands, threats and then punishments) and have noticed that nothing seems to work.

As bishops are learning that there is a different way, they are usually very open to the 12 Steps once they get a clear explanation.  The Romanian Church is an example: the bishops have embraced the 12 Step model and are pushing to have it presented in the seminaries and used in the parishes.

I think the success will catch on the more the work continues.

http://www.mospat.ru/en/documents/social-concepts/xi/

XI. 6. The Bible says that «wine maketh glad the heart of man» (Ps. 104:15) and «it is good… if it be drunk moderately» (Sir. 31:27). But we repeatedly find both in Holy Scriptures and the writings of the holy fathers the strong denunciation of the vice of drinking, which, beginning unnoticeably, leads to many other ruinous sins. Very often drinking causes the disintegration of family, bringing enormous suffering to both the victim of this sinful infirmity and his relatives, especially children.

«Drinking is animosity against God… Drinking is a voluntarily courted devil… Drinking drives the Holy Spirit away», St. Basil the Great writes. «Drinking is the root of all evils… The drunkard is a living corpse… Drinking in itself can serve as punishment, filling as it is the soul with confusion, filling the mind with darkness, making a drunk prisoner, subjecting one to innumerable diseases, internal and external… Drinking is a many-sided and many-headed beast… Here it gives rise to fornication, there to anger, here to the dullness of the mind and the heart, there to impure love… Nobody obeys the ill will of the devil as faithfully as a drunkard does», St. John Chrysostom exhorted. «A drunk man is capable of every evil and prone to every temptation… Drinking renders its adherent incapable of any task», St. Tikhon Zadonsky testifies.

Even more destructive is ever increasing drug-addiction — the passion that makes a person enslaved by it extremely vulnerable to the impact of dark forces. With every year this terrible infirmity engulfs more and more people, taking away great many a life. The fact that the most liable to it are young people makes it a special threat to society. The selfish interests of the drug business help to promote, especially among youth, the development of a special «drug» pseudo-culture. It imposes on immature people the stereotypes of behaviour in which the use of drugs is seen as a «normal» and even indispensable attribute of relations.

The principal reason for the desire of many of our contemporaries to escape into a realm of alcoholic or narcotic illusions is spiritual emptiness, loss of the meaning of life and blurred moral guiding lines. Drug-addiction and alcoholism point to the spiritual disease that has affected not only the individual, but also society as a whole. This is a retribution for the ideology of consumerism, for the cult of material prosperity, for the lack of spirituality and the loss of authentic ideals. In her pastoral compassion for the victims of alcoholism and drug-addiction, the Church offers them spiritual support in overcoming the vice. Without denying the need of medical aid to be given at the critical stages of drug-addiction, the Church pays special attention to the prevention and rehabilitation which are the most effective when those suffering participate consciously in the eucharistic and communal life.

Quick Note

Some readers have complained that this blog is slow-loading and has some other problems.  Shoot me an email if you are experiencing problems viewing this blog.  If there are enough problems, I will look for another host.  Thanks!

Drinking and Culture

Now that we have celebrated one of the ‘great feasts’ of American society, Thanksgiving Day, I thought I would talk a bit about the role of culture in recovery.  Some of us have had a harrowing experience getting through yesterday without relapsing, if only because our families present such a risk!  However, American holidays can present lots of risks just from the social customs, from the ‘traditional’ eggnog spiked with brandy to the seemly-obligatory bacchanalia of New Year’s Eve.

I was raised in a blue-collar American setting, and my earliest memories of vacations often involved drunk firemen engaging risky behavior.  Of course, that was also an era when they were paid less and so had to work harder at having ‘fun.’  There was lots of ‘hard partying,’ and so manhood was demonstrated to me as men who were physically strong and could ‘handle their liquor.’

We always had a jug of wine at the table, and I mean it was a jug.  It was never on the table, but that was because it was so big that it got in the way and was left on the floor next to the leg.  There was also the evening ‘relaxation’ in front of the TV, complete with a cocktail poured into a voluminous plastic tumbler, heavy on the vodka or something else and light on the ice.  Around 2 or 3am, one of us kids had to go and shut the TV off because the off-air tone woke one of us up:

That was my home and my culture, and I did my best to fulfill it into my adulthood.

Part of my own recovery was a turning away from the culture of my childhood.  To be honest, I was not entirely comfortable with it then, but I also didn’t know any better and I thought that it was the right thing to do.  At times, it looked fun (except in the mornings), but most especially it looked to be the way in which a man was accepted by his peers.  A man became ‘honorable’ by drinking.

Recovery means redefining one’s culture.  One can no longer accept the premise that part of adulthood means sacrificing part of one’s humanity, and that certainly was what happened.  Drinking to drunkenness and eventually addiction has deathly consequences, as does drug use and a host of other substance abuses.

That does not mean that the culture is utterly thrown away and rejected, but it must be restored to its original purpose: cultures protect life.  Cultures show us how to raise children, preserve order, keep the peace with our neighbors, and many other good things.  Addiction destroys culture, because culture is about one’s relationship with his neighbor and addiction is strictly about the self.

Addiction breaks up relationship and enslaves men to their worst cravings, while culture gives men ways to build strong relationships and a sense of purpose and belonging the addict craves but can never attain.  Culture breeds a sense of certainty (some cultures are unhealthy, but that’s a conversation for another day), whereas the addict’s life is full of drama.

Part of what any successful treatment program must do, consciously or unconsciously, is redefine the addict’s concept of culture.  He must embrace the healthy parts of his culture more fully and reject its unhealthy aspects more completely.  This is not unlike the Early Christian approach to the Roman Empire before St. Constantine: many saints were seen as model citizens, sans the sacrifices to idols.

We have a new church culture developing in the US as the Orthodox Church grows here and the balance of its membership shifts from immigrants to home-grown, and while drinking and drugs are not as significant of a problem with this new community, many other addictions are.  As our church culture is developing, we must be aware of its healthy and unhealthy aspects.

The Disease Concept

One of the fundamental concepts of addiction recovery is the concept that addiction is not merely a choice to abuse, but a loss of control brought about by a disease.  Addiction is a disease, affecting all aspects of the person.  Another term we use is a disorder.  In either case, what it means is that so long as the person is not healed or brought into another state of being, the addictive behavior will continue.

This concept of disease is also central to the Orthodox Church’s teachings regarding the fallen human state and sin.  Just as the addict first makes choices to drink or use which leads to his imprisonment, men make decisions which lead them into imprisonment to their passions.  The passions are a disease, rooted in the first ‘disorder’ of the Fall of Mankind.  Our humanity is broken and not working properly, and so we need the healing of God’s grace and the humanity of the New Adam, Jesus Christ.

Orthodoxy and AA share the same belief (though the Church has taught it far longer and Christianity’s influence on the development of AA’s beliefs are well-documented) that sin, be it addiction-driven behavior or sinful behavior in general, come from a loss of self-control.  So long as the disease is not cured, the person will continue to be dominated by cravings.  So long as the cravings continue, the addict is subjected to a constant war with himself.

The cure is not to find a better way to control the desire, but rather to have the obsession or impulse ‘removed.’  After all, battles are won and lost, but no war means no loss.  The healing of addiction removes the war itself, just as the healing of Christ, with His new humanity, promises to remove the sufferings and temptations of sin.  The more we are in Christ, the less we are prisoner to temptation and the fight against sin.

Orthodoxy says plainly what AA says indirectly.  After all, the founders were trying to avoid using words and terms that had religious ‘baggage’ (i.e. misunderstood notions of Christ, etc.).  This is why alcoholics, when introduced to the Church, let out a sigh of relief: they find themselves in the fulfillment of AA’s promise’s regarding the return to proper religion and the discovery of the God that helped them in AA was in the Church as well.

A Special Request: Tell Your Story

Back in 2008, I said something to the clergy I was lecturing to in Romania that stunned them: there are quite a number of non-Orthodox alcoholics that end up converting to Orthodoxy because of what they learned in 12-Step groups and the experience of recovery.  I knew it for certain, and I had met others like me who had the same experience.

On this eve of Thanksgiving, I would like to thank God for both the experience of recovery and how it led me to the Church.  I would like to be able to post the stories of other Orthodox Christians who came to the Church through _A (feel free to fill in the missing letter!), or Orthodox Christians whose faith has been deepened because of their involvement in the 12 Steps.

My email address is listed on the blog (priest dot [my name] at gmail dot com, trying to avoid those nasty spam-bots!).  Please send in your stories as you would like them to appear.  Also, any other leads for the blog would be welcome!

Thanks for your encouraging emails so far.  500 visits in the first week is a good sign.  Don't worry, there's a lot of material left to post, and still a lot of work to do.  If you would like to get involved in addictions recovery education, let me know.

Anti-Alcohol Campaigns: Nice Art, Little Accomplishment

Below is one of the most telling images I’ve seen depicting the approach of state-run anti-alcoholism campaigns.  It is the classic Soviet-era ‘icon’ against alcohol…

The Soviet approach was the world-wide one: more self-will is what is needed when people become addicted.  Inspire them to stop, and they will stop.  Remove the alcohol, and sanity will return.

The problem is that it never works.  As you can see in this article, which describes the origins of the art (and how it is now being ‘reworked’ to advertise soft drinks in Russia), Russia (and the rest of the world right now) has had numerous efforts to combat drinking, and in the end the decision to give people their cheap vodka won out, either as the true ‘opiate of the masses’ or merely as a popularity stunt for politicians offer a liquid-version of ‘bread and circuses.’

http://pointsadhsblog.wordpress.com/2011/11/14/just-say-nyet/

Yes, advertising may help combat rampant Coca-Cola drinking and help Russians return to the much healthier ‘kvass’ (the latter of which I prefer, and I’m not a Russian), but advertising against alcohol consumption is akin to thinking that better facial tissues will cure the common cold.

Alcohol and drug usage are symptoms, they are not the problem.  The disease lies underneath the substance.  The substance is the symptom, not the cause.  Take away the symptom, the disease will still be there.

Despite how the message may be delivered, either by slick Agitprop art or ancient Slavic woodcut prints (produced by Communist artists!), admonitions to alcoholics don’t work:

http://pointsadhsblog.wordpress.com/2011/11/07/soivet-temperance-i-with-joint-forces-against-drunkenness/

Compare this with art from the 19^th century temperance movement in the US and Prohibition:

http://thenonist.com/index.php/thenonist/permalink/relics_of_temperance/

http://www.albany.edu/~wm731882/media_during_prohibition_final.html

Prohibition demonstrated that alcohol, unlike marijuana and other drugs, could not be banned for the simple reason that it is so easy to make.  In the end, the desire to drink overrode societal regulations, and this desire was not necessarily coming just from alcoholics.  Plenty of average drinkers (including my grandfather), made liquor and beer simply because they enjoyed it and resented being told that because others had a problem they could not enjoy an occasional drink themselves.

In the end, however, most campaigns carry the same message: will yourself to stop drinking.  This never works for the addict.

A Good Introductory Audio Presentation

The Greek Archdiocese posted this excellent speech by clinical counselor Michael Kallas:

http://www.goarch.org/resources/conferences/trilevel2005/adulted/addiction

It is aimed at average people trying to understand a friend or family member with an addiction, and how to ‘get it right’ in addressing the problem with the sufferer.  It is very basic, and that makes it valuable for those who have never had formal training or long-term experience in dealing with addictions.

All of our parishes could do with a Michael Kallas.  We all need someone to ‘translate’ the addict-experience into something that makes sense, because too often it does not.  His knowledge is especially needed by clergy, since we are often the ones who have to deal with addicts.

I have tried on several occasions to ‘coach’ fellow priests through the maze of the addicted mind when they have been forced to deal with a particular pastoral case that stumps them.  The problem is that the way you deal with an alcoholic or addict is usually in a manner which is totally opposite to how you would deal with a ‘normie,’ and so most priests find that their ‘instincts’ get them into more and more trouble.

Usually, after such an experience, they have more sympathy for ‘enabling’ families that wonder why everything went so terribly wrong even with their best efforts.  If you follow Mr. Kallas’ advice, you will find yourself making fewer bad decisions.

He gives excellent advice on listening, which has become a lost art as we enter the depersonalized era.  Many time, when we are supposed to be listening we are either thinking of the next thing to say or fighting the urge to interrupt, both of which turn us away from the speaker and allow the conversation to devolve into two unrelated inner dialogs rather than alternating speaking and listening.

Antiochian Archdiocese makes a start

The Archdiocese has started an effort to address youth drinking (which it lumps in with smoking).  You can see the approach here:

http://www.antiochian.org/drinking_smoking

The topic of ‘abuse’ is mentioned, but only briefly:

http://www.antiochian.org/alcohol_and_drug_abuse

How abuse becomes addiction is not conceptually linked in these postings.

The difficulty for most youth workers in understanding addiction is that the children who need the most help are not going to come to their activities and fill out their surveys.  By the time full-blown alcoholism develops, the child has usually grown to an adult and long since left the church community.  In America, since we are a minority community and our people are scattered, that means the church can leave the problem to the world.

And, we do.  At least we do have good treatment outside the Church, but it is tragic that we are not equipping ourselves to handle these problems.  In essence, what this means is that the practical experience of Orthodox spirituality must be had outside the parish, diocese, or jurisdiction!

The Antiochian Archdiocese is following more along the lines of a ‘gateway’ approach, the logical assumption being that if children don’t try a substance, they can’t become addicted to it.  The argument also follows that these substances are harmful, addicted or not.  It is total abstinence approach, which is not unreasonable in many respects.

From the point of view of addictions, someone with a predisposition to addictive behavior can become addicted to just about anything.  For example, there are many alcoholics who can stop drinking for long periods, so long as they can engage in another ‘medicating’ behavior.  Many alcoholics report that even something as common as anger at someone can keep them sober even for years.  However, once the target of rage is removed, the old addiction returns.

The problem this model will struggle with is that the real danger of alcohol and drug use is in addiction, and addiction cannot be addressed simply by talking to young people in the parish once a week.  Alcoholism and addiction involve the entire family and the attitudes of the community.  Telling children that smoking is bad for them is not really going to do anything if the child has a predisposition to addiction.  The predispositions need to be addressed, and to do that the entire family needs to be involved.

Since most ‘Orthodox’ cultures frown on acknowledging personal problems, predisposition is usually ignored and goes untreated until the introduction of the substance and full development of the disease.  Not only the Antiochian Archdiocese, but all the jurisdictions, must work on changing the social culture of the membership.  Because American culture itself has largely made the jump, it is not as difficult as it looks.

An effective approach is giving voice to people in the Church who are in recovery, and allowing them to explain to their own community the great power of God they have experienced.  Sadly, more hierarchs and clergy are allergic to this idea than not, mostly because there is distrust of the laity enforced by years of dysfunction which make it such suspicion well-deserved: many laity believe that their lay status frees them from all moral obligations, and they take advantage of this by acting rudely and in a self-serving manner.

This paradigm, however, does not continue with recovering alcoholics and addicts: they understand that they themselves must bear the responsibility of living according to God’s will to the fullest and not excusing their bad behavior.  The essence of this is that the healing of entire communities can start with the clergy and hierarchy accepting and using those in recovery to ‘share the message’ with the flock of Christ.

We must expand our vision beyond targeting ‘kids’ and rather approach the entire family system.  While I do hope Fr. Joseph’s efforts bear fruit, I think we all know that this is only a small part of what must be done.

Getting back to the original subject: what is the difference between ‘abuse’ and ‘addiction.’  Many people can ‘abuse’ alcohol and drugs, but not become addicted.  For example, we all know heavy drinkers or ‘hard partiers’ who maintain good family relations, businesses, and can stop drinking with little effort.  They get drunk and ‘abuse’ by using immoderately, but can stop.

An addict can’t stop.

Abuse can lead to addiction, but addiction develops outside abuse.  It runs deeper.  Not every frat boy who parties his way through college for four years is going to be addict come graduation, and young people know this.  If you try this approach and say that abuse automatically leads to addiction, they will eventually reject the message because it fails the test of reality.

Abuse is bad because it is risky behavior, and addiction is just a small sliver of the other risks: accidents, violence, criminal behavior, etc.  But, what young people crave from the abuse is the ‘good feeling’ it brings.  What is this ‘good feeling?’  People in counseling must understand what it is and incorporate this message into what they are doing in order for the message to be useful.

OCA & Addiction

I have checked around the OCA’s web site, and was able to find through outside searches a few helpful pages on addiction from their own literature (dated 1989):

http://oca.org/resource-handbook/parishdevelopment/it-still-outranks-them-all-part-i

http://oca.org/resource-handbook/parishdevelopment/it-still-outranks-them-all-part-ii

http://oca.org/resource-handbook/parishdevelopment/it-still-outranks-them-all-part-iii

http://oca.org/resource-handbook/parishdevelopment/it-still-outranks-them-all-part-iv

http://yya.oca.org/TheHub/Articles/TheChurchonCurrentIssues/OutranksAllResources.htm

I find the OCA’s website is difficult to navigate, and it took some work for me to find these.  Overall, they are solid and Archpriest Bogdan Djurdjulov is to be commended for an excellent presentation on the topic.

The OCA has had the most public discussions on the topic of alcoholism, due in some part to its political upheavals over the last 15 years.  Without really saying it, the OCA has seemed to have come down on the right side of the matter: addiction, if honestly addressed and treated, is no bar to participation in the Church or even ministry.

Average people might not realize it, but this is very hopeful as far as establishing the Church’s credibility in speaking to this topic.  By not overreacting, but rather allowing even clergy and hierarchs to receive treatment, the OCA has progressed light-years over other churches that would instantly anathematize a clerical addict.

Fr. Bogdan, in addition to Bishop Michael (Dahulich, former dean of St. Tikhon’s Seminary), Protopresbyter Thomas Hopko, and Archpriest John Dunlop have helped provide clergy with an introductory understanding of addictions as they have passed through the OCA’s three seminaries.  The larger impediment to clerical development on the topic usually stems from a lack of continuing education or the priest’s unwillingness to acknowledge that this own brilliance alone may not be sufficient to solve all the problems he encounters.

Oaths, Threats, and Other Half-Measures

When I was in Romania, the big message we were trying to deliver is that alcoholism is a disease.  Most people there still think of it as an issue of self-will, and so the alcoholic could will himself sober but does not.

In Cluj and surrounding Transylvania, this most common 'church treatment' for alcoholism is to take a solemn 'oath' in the church.  What the alcoholic does is visit the priest and, similar to confession, kneels with the stole over his head while swearing off alcohol for a certain period (priests report this is usually a year). 

This seems to help some drinkers, but many priests seem to think it only helps heavy drinkers avoid social pressure to over-indulge (i.e. "Sorry, fellows, I've taken the oath.").  Romanians have a profound respect for the Church, and so most folks would back off pressuring a friend to drink.

Alcoholics, however, will occasionally take the oath and then, a few weeks later, return to the priest and ask for a 'dispensation' to drink at a wedding or social function.  Every priest handles this differently, but most of the priests were highly ambivalent about the whole thing altogether and usually don't argue with alcoholics who ask for a 'temporary stay' on their oaths.

Again, the assumption is the will... with an oath, an alcoholic can will to stop.  Of course, if this were true, we would not have so many alcoholics and addicts!

It appears that Russia has picked up on the disease concept of alcoholism, but their approach is is that it is strictly a physical disease, with neither a spiritual nor a mental dimension.  So, Russians want a 'treatment' no different than chemotherapy or perhaps diabetes: take a pill and make it go away.

Here's an example:

http://www.marketplace.org/topics/world/russia-rx/killer-cure-alcoholism-russia

This Russian method is based on the 'old standby' in American treatment programs, Antabuse (http://en.wikipedia.org/wiki/Anabuse). 

The Russian twist is that the doctor in Russia tells the patient it will kill him, whereas the American addict knows going in that disulfiram won't kill him.  In fact, most American addicts learn that if you want to overcome the effects of disulfiram, you just 'use over it'... drink until the nausea goes away with the regular effects of alcohol.

Disulfiram does not cure the underlying cause of alcoholism, though it may be helpful for a heavy drinker or someone in very early stages of developing addiction.  Clearly, it has not worked in the larger picture of alcoholism.  However, if the general Russian attitude towards alcoholism is that of a disease, then they are ready to take the next step and acknowledge that is is a spiritual disease.

Recovery from addiction is more than just not drinking, it is about being spiritually healed and united with God.  Until the alcoholic accepts this premise and embarks on his spiritual journey, he'll never begin to recover.

Back

I'm recovering from an appendicitis, so I have not been able to post until now.  Thank God it did not happen a few weeks from now, since I would have been in the middle of my Alaska trip.  God's timing is perfect!

The Alcohol Belts of Europe

Here is a chart of who's drinking what in Europe...

http://en.wikipedia.org/wiki/Alcohol_belts_of_Europe

A typical attitude...

I found this posting on the OCA's offical website:

http://oca.org/questions/contempmoral/12-step-programs

The money quote: "While I have personally had little experience with these—I have only had a few parishioners in my 25 years of priesthood who had been involved in a 12 Step Program..."

The priest, who is an all-around fine man and competent Orthodox presbyter, then goes on to basically give an opinion about AA which was largely conjecture.  His conclusions aren't terribly unreasonable, but I think the Chuch needs to do a better job about explaining what 12-Steps are and what goes on within such groups rather than leaving it to guess-work.

The sad thing is that addictions ARE problems that Orthodox face:

http://www.mcclatchydc.com/2009/08/05/73105/biden-had-it-right-rural-russia.html

In 25 years of ministry, the fact that this priest has dealt with so few addictions cases should tell us something: Orthodox Christians leave the Church rather than ask it for help.  Being Orthodox does not make one immune from this disease, though I do believe that Orthodoxy has the right treatment (namely, Christ).  Seriously lived and practiced, the Faith can prevent one from becoming an alcoholic or addict.

But the truth is that most Orthodox don't practice their faith all that seriously, and so many of them do succumb to addiction.  But, the sad follow-on to that is that when they do, many of them feel the Church is only for the 'healed'... or the people in the Church are too dishonest in confronting their own problems to help anyone else with theirs. 

We must never lose sight of the fact that underneath the pagentry of Orthodox worship is the power of God, which is attained through plunging the depths of filth and despair.  Under the brocaid vestments are hair shirts and sore muscles, both literally and figuratively speaking.  Sometimes, we can look 'too good to be true.' 

On the other hand, our parishes are often full of the sick who refuse to get better, and they can drive out those who might challenge them in their 'self-enabling.'  Thus the faithless drive out those seeking faith, since if the latter find it they will have no more excuse for their lack.

If the Church is going to fulfill the commission to those in need, those who are not addicts must be healed and understand how we can offer it to others.  The roots of addiction run through all mankind because all men are afflicted with the passions.

People of the Church would do well to begin to identify more fully with addicts, alcoholics and others imprisoned by sins.  We are too good at demonstrating how apart we are from the rest of humanity, all the while share all of humanity's problems.

The Addicted Brain

This medical study has just been released on the differences between the brains of addicts and 'normies.'

http://www.asam.org/DefinitionofAddiction-LongVersion.html

It is definitely worth the read.

Interview with Fr. Meletios

Here is a short interview on the topic of recovery given by Fr. Meletios to Pravoslavie.ru:

http://www.pravoslavie.ru/english/7386.htm

He speaks in general about the problem of alcoholism and the need to develop differing approaches to recovery based on the social context of the sufferers.

Fr. Meletios' Book

If you want to get a good, reliable introduction to the 12-Steps from an Orthodox perspective, then I strongly recommend Steps of Transformation by Abbot Meletios Webber of St. John of Shanghai Monastery in Manton, CA.

Here is a review page for the book:
http://www.monachos.net/forum/showthread.php?8473-Steps-of-Transformation-An-Orthodox-priest-explores-the-12-steps-(Fr.-Meletios-W.)

Fr. 'Mel' has a profound insight into the topic, and his book is absolutely an essential part of bridging the terminological gap between the Church and AA. 

I've added a link to the book in the sidebar, which you can order from Conciliar Press.

More on Floyd

Here are a few more links to Floyd:

http://addictions.sthermanseminary.org/

http://stdimitrie.org/staff.html

The first is to the seminary, where he has been lecturing when in the US.

The second shows his staff in Cluj, Romania.  I've met all his folks there and they are great.  You have to remember that in Romania, an alcoholic with 5 years sober is an 'old-timer.'  Floyd has had to build up this community from the bottom up, including training the staff and getting a first generation sober so they can sponsor others.

It's really a remarkable story.

Recovery in Romania

I mentioned Floyd in the previous post, who has become the 'godfather' (in the not-kneecap-breaking sense of the word!) of Orthodox recovery programs. Here is a link to his OCMC page:

http://www.ocmc.org/missionaries/missionary_profile.aspx?MissionaryId=4

Floyd is responsible for getting the Church of Romania to recognize the effectiveness of the 12-Step program for the treatment of alcoholism, and now his materials are being integrated into the seminary curriculum in Romania's schools and he has been tasked with training thousands of Romanian priests in how to establish AA groups in their villages and towns.

The Romanian Church is also working to set up in- and out-patient treatment programs which use the Minnesota Model for clinical treatment. Gradually, Patriarch Daniel of Bucharest (who has supported Floyd's work from the beginning when he was Metropolitan of Iasi) is getting the entire Church to embrace Floyd's work.

In 2008, I spent a few weeks with Floyd and we did trainings in three cities. It was very fruitful: Floyd has 30 years of experience in recovery and treatment, and so he is able to speak from his wealth of knowledge on how to engage in the treatment of addictions.  My ‘area’ so-to-speak has been the integration of Orthodox spirituality with treatment: they have common assumptions and methods, separated by a gulf in terminology.

AA is limited because it can only return people to a ‘church,’ but it does not claim to be a church.  We are the Church, and so what addicts and alcoholics are really looking for is ‘us.’  Once the parallels are established, Orthodox Christians can easily grasp what 12-Step programs do, and 12-Steppers can see that the God they are searching for is found in His fullness within Orthodoxy.

Floyd has been ‘carrying the message’ in Romania for over a decade.  The fruits are already showing:

http://www.ortodoxantidrog.ro/en/start.html

What is happening in Romania is a cooperation between recovery groups and the Church.  It is an exciting new chapter in the world of recovery, though little noticed at this stage.

St. Herman's Seminary

I'm getting ready to do an OCMC mission trip to the seminary in Kodiak, AK.  Several of us, including Floyd Frantz (long-term missionary working on alcoholism treatment in Romania), will be lecturing on various aspects of alcoholism and its treatment.  The lectures I will be doing are:

The Spiritual Disorder of Man and Addiction
Theosis and Recovery
The Person and the Group
Recovery within the Parish & the Diocese
Spiritual Counseling & Sponsorship

I'm going to bring my recording equipment, so hopefully I can get some decent audio out of them to post.  Being a technological dummy, any suggestions would be appreciated.

YouTube Channel

Here's a link to my YouTube channel, where I explain some of the basics of Orthodoxy in a not so 'technical' way.

http://www.youtube.com/user/PresbyterGeorge?feature=mhsn

Most of the important teachings of the Church are very simple, but we usually run into problems understanding them because we either project meanings onto the word being used to describe these teachings, or the teachings use technical gargon that people don't understand.

One of my goals is to 'translate' Orthodoxy into the language of this era.  This isn't a new job, and it is going on throughout the world right now.  People re translating from Greek, Slavonic and a host of other languages into English because it has become the latest international language.  However, English is fluid, and the translations of 100 years ago don't necessarily work today.

I'm not really fluent in any 'Orthodox' languages, but it seems to me there's plenty of translating needed from English into English...