midlifedude

Man at midlife making second half matter

Archive for the category “rehab”

‘Play the Whole Tape:’ The Struggle of Addiction

Alcoholic_AAMtgThe lanky young man with the tattoos took a break from his intricately-detailed pencil-sketching to look up from his art and turned to face me after I introduced myself to the group.

“Have you ever been addicted to drugs?” he asked.

“No,” I responded.

“Ever been addicted to alcohol?”

“No,” I said again.

“What can you know?” he mumbled with disgust and turned back to focus on his artwork.

It was my first day as a co-leader of a substance abuse therapy group, an internship for my clinical mental health counseling master’s degree as I make a career transition from public relations to counseling. The group leader smoothed the edges by telling the group members they can learn different things from counselors who had addiction problems and those who haven’t. The leaders with whom I have worked had substance abuse histories and can talk the language of the streets and drug culture; I can’t.

When a member glorifies the days of using, as those in substance abuse recovery are wont to do, one leader admonishes: “Play the whole tape,” meaning remember the misery that accompanied the action, the “ripping and running.”

Later in the session, the young man apologized to me and the group for his abrasiveness, saying he had discovered just before the session that a good friend from childhood had died by drug overdose. That type of emotional volatility and chaotic, unpredictable life is common among members.

In my two months co-leading and leading this three-hour-long group session, I have learned from members and have become more comfortable guiding and interacting with them. The members provide a fascinating window on life’s struggles and many life themes: redemption, commitment, determination, acceptance, grace, hope, resilience, courage, meaning, generosity, self-centeredness, self-destruction, temptation and despair.

Group members represent a microcosm of society: male and female; fathers and mothers; black, white and Hispanic; teenagers to seniors; those from childhoods of abuse, neglect and deprivation and others from relatively stable, caring families; workers and jobless; people doggedly seeking change and others going through the motions.

Some have been homeless, shunned by family members. Many have been imprisoned, and some still are dealing with charges that could result in jail time with any transgression. Some have risked their lives to get drugs, running dangerous streets at all hours, banging on doors of drug dealers. They have lost children, jobs, health, relationships, dignity, trust and respect over their addictions. Many have been through rehab before, but reverted to previous habits, some as soon as they exited. Their emotional lives have been engulfed with fear, shame, guilt, resentment, anger and damaged self-worth.

I don’t have any particular unique or profound insight into the scourge of addictive behavior and those who come under the influence of alcohol and drugs. I only have impressions as a person and professional new and fairly oblivious to this world. My biggest takeaway is that these individuals are not addicts, but people with addictions. In our society, we tend to apply labels to people that come with proscribed traits and characteristics, effectively straight-jacketing people into circumscribed boxes.

The experience has reinforced for me that addiction does not define the group members, a lesson I also learned first-hand when a roommate suffered a relapse. In fact, addiction is not at the core of their being at all. They are so much more than “addicts.” I appreciate the regular group members I have gotten to know for their sense of humor, loyalty, caring, openness, friendliness, raw honesty, suffering and commitment.

One woman exemplified the power of passion, hope and resilience – and the difference between those who truly accept and want to beat addiction and others who may be biding time – in an activity I led challenging the members to identify their strengths. Some struggled to come up with more than two; a few others declined to offer even one when called upon to share. But this woman, for whom the phrase “to hell and back” would apply, rattled off about a dozen assets. She appears to want recovery bad; her emotional pain is palpable. She has a medical condition that might keep others away, but she refuses to miss or give up. She’s a good person who got some raw deals in life and made some regrettable choices that sent her into a downward spiral, like many of the members, and she’s developing the courage to own it all. She is recognizing her worth as a human. She expresses faith.

I’m pulling and praying for her and the others to beat their addictions and find serenity and contentment, and hope I can be a positive influence, however small, on their recovery.

 

Thoughts on Struggle, Resilience, Gratitude and Grace

Counseling has given me a new perspective on struggle, resilience, gratitude and grace, at this time of year when we may slow down enough to think about these phenomegracena.

I’m working as a therapist intern at a mental health agency in Baltimore that serves low-income clients. Many have substance abuse problems. Some have been drug dealers. Some have spent time in prison. Many have been victims of crime or domestic abuse; some have perpetrated violent crimes.

Some have been homeless or evicted with no place to go, and some are on the verge of homelessness. Some are shunned by their families. Some were criminally abused or neglected as children.

All are struggling mightily, yet they have resilience. They want better. They want to overcome. They don’t quit. The question, however, is always: How motivated are they to change? When I think about resilience I’ve had to summon to face challenges, it doesn’t compare.

Many of our clients are on the margins of society, nearly invisible. Many have dropped out of the job market. Some want to return, but it’s a struggle to re-enter. Some have become isolated or reclusive, out of distrust or fear of failure, rejection or disappointment. They want independence, but it’s a struggle to get there; many have to lean on others for help. It’s easy to see: Once you fall into a hole, the climb to emerge can be arduous.

They are grateful for people who care about them, whether a therapist, a social worker or a friend or family member who stuck by them during difficult times when others didn’t. They are grateful for sobriety, kids and grandkids, and new chances.

Our clients inhabit a world and have lived through experiences with which I had no familiarity until my counseling internships. For the clients who have let me into their worlds and taught me about the enormous challenges they both inherited and created themselves, I am grateful. They have blessed me with a real-world education that books and classes can’t approximate. I hope I am providing a certain kind of education for them in return.

As for grace, Gerald G. May, M.D. described “living into grace” in Addiction & Grace:

“Living into the mystery of grace requires encountering grace as a real gift. Grace is not earned. It is not accomplished or achieved…It is just given.

“But living into grace does not depend upon simple receptivity alone. It also requires an active attempt to live life in accord with the facts of grace [which]…are simple: grace always exists, it is always available, it is always good, and it is always victorious…

“The risk, of course, is to my addictions; if I try to live in accord with grace, then I will be relinquishing the gods I have made of my attachments…I must make conscious efforts of will; I must struggle with myself if I am going to act in accord with those facts. Living into grace requires taking risks of faith.”

As we enter a new year, I hope and pray our clients are able to recognize grace working in their lives and find the strength to take the risks of faith to live into grace.

Drunken Debacles

Ed’s Chicken & Crabs, referred to by my family as Ed’s Chicken Shack, a landmark in laid-back, party-hard Dewey Beach, DE for nearly 40 years where you could order consummate beach dinners of crabs, chicken, fried clams, hush puppies and corn on the cob from the take-out window and eat on picnic benches outside as the sun set, was reduced to a pile of charred wood and scorched, twisted metal in a fire this summer.

edschickenshackburned

Ed’s Chicken & Crabs, a Dewey Beach institution burned to the ground by a drunken driver.

 

The fire wasn’t caused by a kitchen or grease mishap. Neither was it caused by an arsonist, a careless smoker or an electrical misfiring. Unbelievably, it was caused by a drunken motorist at 2 a.m. who crossed the raised road median on Dewey’s main drag and four lanes of traffic and slammed into a propane line in the eatery, igniting the blaze.

Luckily, the 36-year-old woman’s life was saved by first responders. The owner of Ed’s and its devoted Dewey Beach patrons weren’t as lucky. Ed is 83 years old and said he doesn’t plan to rebuild. A drunken woman put him out of business and left an eyesore of rubble in the middle of the classically honky-tonk beach town.

A beach institution is destroyed and a man’s livelihood and surely a piece of his soul wrecked by a brazen act of drunkenness committed by someone of an age where one would hope maturity and individual responsibility would triumph over atrociously bad judgment and decision-making. But that is not always the case when alcohol is involved, as Baltimoreans witnessed in the death of cyclist Tom Palermo, run over on a sunny afternoon by a drunken, high-ranking clergy member.

Speaking of drunken debacles, I experienced first-hand observation of a rapid descent into the throes of alcoholism during my summer in Bethany Beach, DE. An adverse life event pushed someone I was close to into a multi-week, nonstop bender. I had never seen alcoholism so up-close and devastatingly real before.

The fall was incredibly rapid and far by someone who said he had been sober for three years. In the course of a few days of drinking, I could barely recognize this person from the one I knew previously, sober. It was a stunning and sad transformation, and no one could do anything about it but the drinker.

A recovering alcoholic who knew both of us counseled me about what I could expect from my friend. Don’t believe everything my friend said and expect the friend to do things in secrecy out of shame, the sober recovering alcoholic told me. Expect the plunge to go deeper and deeper until my friend ends up in the hospital or in jail, he said. That nearly did happen – my friend hurt himself physically on several occasions, got kicked out of a bar/restaurant, and had to be picked up from the roadside.

Finally, the recovering alcoholic advised, don’t expect my friend to be able to pull out of drunkenness by sheer force of willpower. That display of personal strength against the pull of alcohol rarely happens, he counseled.

He knew from experience, that of himself and many friends and acquaintances he had met through his own journey to recovery. The first step, he said, is the alcoholic realizing he needs help, wanting help, and being ready to seek help. Detox, professional help and support is necessary for recovery. And that can’t happen until the lies to self and others stop, he said.

I tried to offer my friend help as much as I could. But, as the recovering alcoholic advised, you can’t force an alcoholic to accept help, you can only offer, and often my friend did not take me up on my offer to seek the help he needed.

Sometimes I sought to help, but in the wrong way. Like the time when my friend, who did not have a car, wrecked his bike and messed up the chain. My friend was unsuccessfully trying to fix the chain at 11 p.m. and called for my assistance. Why the obsession to fix the chain so late at night? The bike was his only source of transportation and a necessary component for refueling the binge.

Eventually, both of us went our separate ways. We were each there only for the summer, like so many people who are employed in a beach town. My friend got his act together enough to leave town for his next stop. But like many alcoholics, he was overwhelmed by  logistics and decisions.

I don’t know yet if he was able to pull himself up from his fall through sheer force of will – against the odds, as the recovering alcoholic explained to me – and get back on a good track. I truly hope so, or if not, that he got the help he needs. He will always be my friend for the experiences we shared together, good and bad, and I will always remember him for those same reasons, whether our paths cross again or not. I learned a lot from him – not just about alcoholism, which is important knowledge in the line of work I’m entering, counseling, but many other things of positive value.

I wish my friend safety, health, sobriety and Godspeed – freedom from the devastating effects and ruined relationships caused by alcohol. He will always be my friend – a good, well-meaning and caring person at heart who also happens to have an alcohol problem over which he must be constantly vigilant.

Thanks Dr. Dave

AdamBumWheelWithRebFour years ago April 26, I suffered one of the worst nights of my life. One moment I was playing rec league soccer, running after a 50-50 ball. The next, after a reverberating THUD, I was on my back, dazed, wondering what had just happened. It only took a second to realize I had a shattered leg, and within minutes, paramedics were hoisting me onto a transportable bed and loading me into an ambulance.

On the ride to the hospital, I realized my life had suddenly changed. My immediate fear was that I would never be the same again. I had never been injured that badly before.

The story of my challenging rehab – physical, emotional and spiritual – is detailed here.

With the knowledge gleaned from my counseling classes and experience in counseling clients in my current internship, I would hope I would be able to think more positive and optimistic thoughts in the future when something bad happens to me. I struggled to overcome negative thinking and emotions in the early stages of my recovery. I was told I would have a full recovery, but I couldn’t help having doubts.

I often pass the field where I was injured, on the way to and from my university, including at night, when the field lights are bright, just as I remember from my back while staring into the dark sky on the night I got hurt. It brings back memories that I now embrace as an experience integral to my life. It wasn’t cancer, and I’m grateful for that, but it was a type of adversity I had never faced before.

At this time of year, I also always remember the doctor who performed the surgery to put my leg back together. In an amazing coincidence, it turned out the surgeon lived in my same townhome community, but I did not know him. In a sign that I’m getting older, Dr. Dave was about 15 years my junior. After the surgery, as I was hobbling around the neighborhood on crutches, I would run into Dr. Dave walking his dog. He would always challenge me to do a little more than I thought I was capable of – put more weight on my leg, begin walking sooner. We became friendly.

I will be forever grateful for Dr. Dave. He gave me my life back – at least the physical life that I knew and only fully appreciated after it was taken away.

Dr. Dave eventually moved to California to specialize in spinal surgery. It took more than a year to recover to 90 percent or more. But just more than a year after surgery, I completed a triathlon. A neighbor who was at the event texted Dr. Dave, who replied, “Awesome!”

I did the triathlon again two years later, three years after surgery. That time I got Dr. Dave’s number and texted him myself to let him know how grateful I was for his skill and expertise, and that I was as close to 100 percent as I could be. Dr. Dave was glad to hear it, but to him, it was probably no big deal. That’s just what he does, he fixes broken people. Still, I figure doctors who heal probably don’t always hear the appreciation and gratefulness for their work after the patient disappears.

I will honor Dr. Dave with a prayer of thanks at this time every year, as I am sure he is healing many other people with fears like me, and hopefully also with a call or text. Thank God for people like Dr. Dave.

Down and Out

Recovering from surgery for broken tibia, fibula

Recovering from surgery for broken tibia, fibula

Lying on my back, looking up at the stars and stadium lights and the sweaty faces circling me, the terrifying thought flashed through my mind: “I’ll never be the same again.”

Seconds before, a crossing pass came rolling slowly from the sideline toward our goalie box. As a defender, I instinctively broke for the ball. I also broke my self-preservation rule – avoid reckless collisions – but I couldn’t predict it soon enough. As I got to the ball, so did a strapping young opponent, coming full-speed. He swung his leg like a nine-iron, attempting to score. Players arriving for the next game said they heard the “thwwaaackk” a field away. I went down. I thought it might be bad, but didn’t know. Just a bad bruise? I was afraid to look.

Play stopped. Players gathered around me. “Probably a broken shin guard,” I heard. Someone helped take off my shin guard. It was fine. I peered haltingly at my lower right leg and knew I wasn’t. We had a surgeon on the team. All she could offer was, “I’m sorry, Adam.”

Another teammate gripped my hand. Others began asking me questions. “What’s your wife’s number?” “Which car is yours?” “Where’s your bag?” Within minutes, I was being wheeled by paramedics to an ambulance. “What’s your birthday?” they asked, the first of many times I would hear that question that night, to evaluate my alertness, I guess. That and, “What’s your pain level, 1 to 10?”

I stayed conscious and alert through the trip to the ER, surprising myself that I didn’t go into shock or even feel overwhelmed by pain. I had a broken tibia and fibula, two main bones of the leg – a “tib-fib” in orthopedic jargon. The next day I had surgery, a rod and screws inserted, and embarked on the greatest test of adversity in my life.

I had made it to 49 without ever being seriously injured or having surgery. In an instant, to go from sprinting to (pardon the political incorrectness) crippled, is an absolute shock. Prognosis: full recovery, 6 to 9 months. I would learn in the coming months that the injury and surgery didn’t just affect an isolated part of my leg, but distressed my toes, foot, ankle, Achilles, calf muscle, knee – the whole kinetic chain.

I had played in a high-caliber co-ed recreational soccer league for seven years, starting at age 42 – 30 years after last playing. I stuck with it long enough to become a decent defender, and eventually team captain when no one else wanted the job.

More than 120 games, with nothing more than the occasional pulled muscle or bruised rib. It became a point of pride to be perhaps the oldest player in the league, competing against former high school and college players in their 20s and 30s, but it was getting harder.

Maybe ego got in the way, or nostalgia, trying to recapture a vestige of youth. Maybe I should have quit. I almost did several times, but decided “just one more season.” Now, barely able to bend my knee or get off the couch without great pain, I punished myself mercilessly for that decision.

I was angry at the player who hurt me. Problem was, I had no idea who he was. I was told he stood behind me as I lied on the turf that night, looking concerned. But I never heard from him. With no external target, I turned my anger and blame inward.

I blamed myself for decisions I made from two seconds before the accident to months beforehand that could have changed the devastating outcome:

“I shouldn’t have gone for that 50-50 ball.”

“Why did I go back in the game as a sub in the second half?”

“If I had only registered for a Thursday night graduate school course instead of Wednesday, I would have missed the season.”

In the first month after my injury, I continually ruminated about these scenarios, often in the wee hours of the morning between restless bouts of sleep and groggy interludes of cable TV movies and cheesy mystery novels – but of course it changed nothing.

With a walker, just like the near-death seniors at the assisted living facility up our street, I struggled to make it to the end of our 50-yard row of townhouses, and needed my wife to bring a chair so I could rest for the trip back home. Going upstairs on my butt was a chore, so the living room became my bedroom. I didn’t take a real shower for weeks.

I missed three weeks of work, which was just as well because I couldn’t focus, and didn’t drive or wear a shoe for two months. Cooped up and growing depressed, the days became interminable, and I dreaded trying to sleep at night. I had in-home physical therapy – boring and sometimes painful leg exercises, with a lady who scolded me that I would have trouble growing old with my downbeat attitude. But I did the exercises religiously, structured my day around them, multiple sets per day, even strapping a dumbbell or a big flashlight to my heavy, protective knee-high boot to strengthen my leg. But it atrophied anyway.

I was miserable and wallowing in self-pity. If I kept it up, I wouldn’t have blamed my wife if she had walked out, “in sickness” be damned.

I had been athletic all my life — a collegiate tennis player who still played competitively – and now I was struggling to do a lap around our kitchen and living room on crutches without falling. I had the distinct feeling that the world was going on without me.

I started outpatient physical therapy with great trepidation. I imagined the therapists as heartless drill sergeants, pushing me to do masochistic exercises to see how much pain I could endure before collapsing in humiliation. Wrong. I soon embraced my sessions as part of my recovery.

In my early days of rehab, my favorite part of the day was just before bed, after a hot shower, when I lied on the bed and strapped an ultrasound bone-healing unit to my leg for 20 minutes and watched the NBA playoffs, forgetting about everything. I found myself empathizing deeply with players who suffered leg injuries – Derrick Rose of the Chicago Bulls and Baron Davis of the New York Knicks – now really knowing what an arduous road they faced.

I turned the corner and began rejoining life when I learned to use crutches more confidently. I would break up a work-from-home day with a laborious 1/5-mile walk to the neighborhood park about the speed of a kindergartner on 90-degree June days, sweating through my shirt and exhausting my arms, collapsing on the bench for a Gatorade break before the return trip. At night, I would take one of my kids with me until sunset.

I got stronger. I began going distances, about a mile along a path to the Lakefront in town for summer festivals and concerts, and just to sit on a bench with my son.

In late June, two months in, I mustered the courage to go to the neighborhood pool for laps. For the rest of the summer, I swam like my life depended on it, rarely missing a day, often closing down the pool after work. As the pools closed for the summer and healing progressed, I transitioned to cycling and gradually added tennis to the regimen in late fall, slowly increasing my lateral movement.

My new physical therapist told me recovery would be like a rollercoaster, and it has been. I went from two crutches, to one crutch, to no crutches, then back to one crutch as pain in my knee and swelling in my ankle made my gait uneven, then again to two crutches for a while, before finally weaning my way off. Pain and discomfort has flared and subsided regularly. But like the surgeon said, in my eighth month, I started feeling closer to normal, like this too shall pass.

Throughout my ordeal, I progressed from denial to acceptance to ownership. Ironically, the graduate course I was taking at the time of the injury was Theological Anthropology – an exploration of the influence and meaning of God and spirituality in our lives and the world. I came to view my injury as having deeper meaning – the response to adversity, nobility in suffering, a preparation for things to come. I didn’t even want to trade it away anymore, because then it wouldn’t even be my life, my unique experience, but someone else’s.

It was tremendously humbling. Who are you if you can’t do what you’ve always done? It gave me the perspective of living with a disability. I parked in “handicapped” spaces. Near-strangers asked what happened and offered their sympathy, welcomed or not. With my crutches and boot, I felt like a conversation piece.

It ate away at me that the player who injured me had never contacted me. I guess I just wanted to think it mattered…I mattered. Just after Thanksgiving, seven months after the injury, I e-mailed the player’s captain to say I was recovering and that I forgave his teammate. He responded that his teammate felt really bad about it, and it was his idea to send me the Get Well card with a $50 Amazon gift card way back when.

I still never heard directly from that player, and never will. But I never thought about it again. I guess that’s part of learning how to heal – physically, mentally, and spiritually.

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