midlifedude

Man at midlife making second half matter

Archive for the category “substance abuse”

Man in the Mirror: ‘Compare In, Not Out’

In the substance abuse therapy group I co-led as an intern, the group leader would tell members to “compare in, not out” when he detected a member analyzing whose addiction was worse than another’s, assessing who among members engaged in more risky or reckless behaviors or seeking salacious details about others’ misfortunes and misadventures.

The leader’s message to the addicts was as clear as the typical pre-school teacher’s emphasizing individual responsibility and self-control to easily distracted and influenced children focused on others: “Worry about yourself.”

It’s a simple message, but one that takes discipline and introspection to implement, whether for the purpose of changing addictive behaviors or many other goals or pursuits in life in which the temptation is to compare ourselves to the status, abilities, fortune and accomplishments of others. The era of social media has compounded the phenomenon of “comparing out” through the instantaneous access we have into the windows of others’ lives – their new jobs, kids’ achievements, lively social gatherings, adventurous vacations and other things of which to be envious.

We would be more satisfied with our lives if we would “compare in, not out.” To me, “comparing in” means evaluating myself according to my assessment of my own Man in Mirror 2potential, my ability to strive for and attain goals I believe are worth pursuing, being happy with what I have at any given time rather than desiring what I don’t, and living life in a way that makes me feel positive about my actions, conduct and treatment of others, even though it will be far from perfect.

Still, living life without “comparing out” is a challenge for me, as I imagine it is for nearly everyone who hasn’t mastered some form of meditation or inner peace.

Right now, I am struggling against “comparing out” as I begin my second summer as a seasonal tennis instructor at a large beach resort tennis club, a “gig economy” interlude as I make a career transition to counseling.

Among the instructors, several of whom are year-round employees, it is apparent that I am ranked lower in the pecking order, understandably and justifiably as a seasonal staff member, similar to last summer. I know what I have to do to be successful is to conduct each clinic and private lesson to the best of my ability, stay upbeat and high-energy, engage clients in a friendly, interested and courteous manner, and work cooperatively with the staff as part of a team. But I still find it hard to resist comparing the assignments and the number of on-court teaching hours I get – which determines income — to others. Such “comparing out,” and the ruminations it causes, only makes me feel worse; on the other hand, “comparing in” when I give my all for a lesson or clinic, or assist a fellow instructor when needed, makes me feel positive.

My career transition from public relations to counseling is another area where I have to fight the lure of “comparing out” and instead “compare in,” basing my assessment on what I deem is fulfilling and achieves a sense of purpose. Though there is potential for income growth with the establishment of an independent counseling practice in the future, my first job in the profession likely will pay about half of what I was making in the public relations position I left. Eyeing the reality of my pending job search, it is challenging to avoid “comparing out” to other professionals in my age group who may be at the height of their earning potential and aren’t worried about scraping by. That’s when it’s important to “compare in” and realize I chose this path for a reason and I am fully responsible for my decision and the outcome.

“Comparing in” is difficult because it puts the onus squarely on us for our own successes and failures, our current condition in life, our decisions and behaviors, and, perhaps most importantly, the way we feel about ourselves and our own satisfaction and happiness. When we compare ourselves only to our own standards, goals, morals, ethics and beliefs, we strip away self-delusions and rationalizations and are forced to see only the “Man in the Mirror,” our only true compass.

Midlife Men and Divorce: Risky Business

For the capstone class – the 22nd! – of my 5 ½-year master’s degree program in clinical mental health counseling, I had to choose a narrow “clinical population” for a research project. Somewhat shamelessly, self-servingly and unimaginatively, I essentially chose myself: a midlife man who has experienced divorce.

The findings were not pretty for the divorced midlife’s male’s future, though I acknowledge I intentionally selected research that highlighted why this population would be candidates for mental health treatment.DivorceHeartPhoto

Research has come to varying and sometimes contrasting conclusions on divorce and midlife men (roughly age 35 to 60), and mitigating factors are difficult to account for. However, numerous studies have shown that midlife men who have experienced marital breakdown have had greater propensity to become depressed, anxious or develop other psychiatric disorders; abuse alcohol or drugs; suffer from higher rates of illness, earlier death and suicide; harbor anger; live with loneliness and social phobia; qualify for work disability; and experience lower levels of physical health, mental and emotional well-being, and happiness and self-esteem.

And the majority of time, men aren’t the ones pulling the trigger on divorce, which studies show is one of the most psychologically distressing events in life. Research indicates that wives frustrated by an inability to improve their troubled marriages may be more likely to end them, with one study concluding that husbands initiate only a quarter to a third of marital separations.

These are research-based outcomes of divorce that pose challenges for the midlife man:

  • Recently divorced men were more likely than other groups to receive psychiatric treatment and be prescribed medication for mental health disorders. One study concluded that major depression was nine times higher among men who had been separated or divorced compared to stably married and single men.
  • Remarriage in midlife brings with it a whole new set of complications and negotiations that cause stress, indicating that marriage alone does not prevent mental and physical problems. One study found that remarriage was associated with an increased risk of depression compared with men who remained divorced.
  • Men often rely on their wives for their social lives and support for their health and emotional well-being, as women generally have stronger social support networks. Without their marriage, men can become prone to social isolation and loneliness.
  • A common dynamic of divorce is “non-acceptance” of marital dissolution. The ongoing feelings of attachment are associated with depression. The reality for some divorced fathers is continuing angry disagreements with and hostility toward their former wife a decade or more after breakup.
  • Once divorced, men’s physical health can decline, as wives often assume a role for monitoring and influencing their partner’s health behaviors.
  • While women experiencing divorce were at higher risk for mood and anxiety disorders, men were at higher risk for new substance abuse disorders. One study indicated that divorced 46-year-old men comprised a disproportionately higher share of binge and heavy drinkers compared to other groups of the same age.
  • The mortality risk for inconsistently married men (those who had divorced and remarried) was more than 40 percent greater than for consistently married men, and men who were currently separated or divorced had a mortality risk 2.5 times greater than consistently married men.
  • Men who had been divorced had a higher prevalence of work disability many years after the initial divorce.

As for me, I was the prototype of the midlife divorced male: separated at 42 and divorced at 45 in an action initiated by my ex-wife, with two pre-adolescent kids. I also have remarried, and while my wife Amy has been a wonderful social and emotional support, as the research indicated about wives, the second union has inevitably come with some stress due to new family dynamics and inter-relationships, financial complications and psychological adjustments.

I have avoided many of the pitfalls of the midlife divorced male, such as substance abuse or physical health decline, but did not escape divorce unscathed. When first threatened with divorce and teetering on the brink, I suffered from depression that affected my appetite, sleep, energy level and concentration. I struggled with non-acceptance when the reality of pending divorce flooded me like an unstoppable tidal wave. I lost a big chunk of my social connections and outlets. Worst of all, it was hard not to feel like a failure at something so important, and as a letdown to my kids.

Researchers have come to different conclusions over whether such a thing as a “midlife crisis” really exists, or whether it is a pop culture phenomenon, especially for men. But there’s no doubt that midlife is the time men walk through the landmines of marital upheaval, and when they are most prone to its potentially harmful and long-lasting mental health effects.

 

‘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.

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