One Day at a Time: Solid Advice, In and Out of Recovery Circles
By Jeff Vircoe. This article was originally published July 7, 2017. Updated February 10, 2021.
If you judge the advice “live life one day at a time” by how often it is said, it has high value. Spiritual and religious leaders, philosophers and psychologists, and all kinds of self-help advocates frequently offer up the suggestion of living life in manageable increments.
When it comes to recovery, the One Day at a Time philosophy is a staple of wise counsel. Certainly, the co-founder of the 12 Step movement, Bill Wilson, understood the therapeutic value of such a simple but inspiring idea.
“On a day-at-a-time basis, I am confident I can stay away from a drink for one day. So I set out with confidence. At the end of the day, I have the reward of achievement. Achievement feels good and that makes me want more!” Wilson is quoted saying in the A.A. conference-approved book, As Bill Sees It.
One Day at a Time, Now More Than Ever
As we enter the start of a second year in an unprecedented global pandemic, we continue to struggle with questions most of us never thought we’d have to answer. It’s the new normal to ask, when will schools resume safely and businesses recover? When will most of us return to in-person work? Will I remember not to stand up during a Zoom call and reveal my sweat pants?
How much longer can I continue to cope with the physical risks and mental strains that are burdening me and my family?
Why am I always tired? Am I worrying too much?
How much longer until I can finally go back to an in-person A.A. meeting?
In modern times, most people seem to associate recovery and One Day at a Time as being synonymous. Asked about his prolific writing history, Canadian rock icon Neil Young once said, “I just wrote one song at a time. Kinda like an alcoholic. One day at a time.”
However, now more than ever, the idea of “one day at a time” is applicable to all of us, all the time. COVID-19 may not be resolved today or tomorrow, but it will be one day. Until then, we can all treat ourselves with compassion by staying in the moment and focusing making the most of the day we have ahead of us.
Taking Sobriety One Day at a Time
One Day at a Time is found in A.A.’s basic text book, the Big Book, of course. On page 85, Wilson reminds us that, as individuals with addictions, we are not cured of our illness just because we have abstained for some time.
“What we really have is a daily reprieve,” he wrote, “contingent on the maintenance of our spiritual condition.”
When you ask people in the business of addiction treatment who are also in recovery themselves, you quickly find that One Day at a Time is advice they sincerely give and live by.
“For me, it’s about that freedom to start over. There’s a real freedom from the shame and guilt that would immediately hit me. It’s about gratitude of having that gift of a daily reprieve,” says Rebecca P.*, a woman with over 25 years in recovery in family programs.
“It means being present in the moment and focusing on now. Letting go of the past and, especially for me, God, I want to control the outcomes, I want to worry about the future and I want to live in my self-centered fear. This is an alternative to that.”
“It’s about gratitude of having that gift of a daily reprieve”.
Sergio O., a man with over 29 years clean in Narcotics Anonymous, sees One Day at a Time as essentially being the same as N.A.’s frequently used mantra “Just for Today.”
“Just for Today to an addict means there is a responsibility to stay clean just for today. The addict mind always worries about what? I’m going to have to stay clean the rest of my life. So, he never stays in the moment. Just for Today helps the individual to stay clean just for today,” says Sergio, who has been helping addicts find recovery for over a quarter century.
“As you go on deeper into recovery, then the second stage of recovery, as I call it, happens,” he says. “Life gets real. We try to solve the problems of the future. So, that’s when we start learning to take responsibility just for today. When it comes to people, places and things we learn to be responsible, just for today. To stay in the moment.”
Living one day at a time does not mean swearing off drinking or drugging with other substances or behaviors forever, even though we know that’s what we need to do. In the A.A. Pamphlet This is A.A.: An Introduction to the AA Recovery Program produced by the fellowship in 1984, the authors put it this way.
“We take no pledges, we don’t say that we will ‘never’ drink again. Instead, we try to follow what we in A.A. call the ‘24-hour plan.’ We concentrate on keeping sober just the current twenty-four hours. We simply try to get through one day at a time without a drink. If we feel the urge for a drink, we neither yield nor resist. We merely put off taking that particular drink until tomorrow.”
It goes on to say:
“Today is the only day we have to worry about. And we know from experience that even the ‘worst’ drunks can go twenty-four hours without a drink. They may need to postpone that next drink to the next hour, even the next minute — but they learn that it can be put off for a period of time.”
One Day At A Time for Everyone: You’re Not Alone
One Day at a Time has more than its share of recovery angles, but it also has practical meaning for many not in recovery.
Mikao Usui, the founder of Reiki, wrote five affirmations that became the principles of Reiki.
Just for today:
1) I will not be angry
2) I will not worry
3) I will be grateful
4) I will do my work honestly
5) I will be kind to every living thing
Powerful suggestions to live by, one day at a time, Usui advised. A host of others echo similar sentiments.
“Life is like an ice cream cone. You have to lick it one day at a time,” Charles M. Schulz, the creator of Charlie Brown, Snoopy, Lucy and the rest of the Peanuts cartoon gang once said.
U.S. President Abraham Lincoln once referred to the slogan this way: “The best thing about the future is that it comes one day at a time.”
Even Pope John XXIII, the top man in the Vatican from 1958-1963, believed in the same principles contained in the slogan. He released a Top 10 list of tips for living a better life day by day, known as The Daily Decalogue of Pope John XXIII:
1. Only for today, I will seek to live the livelong day positively without wishing to solve the problems of my life all at once.
2. Only for today, I will take the greatest care of my appearance: I will dress modestly; I will not raise my voice; I will be courteous in my behavior; I will not criticize anyone; I will not claim to improve or to discipline anyone except myself.
3. Only for today, I will be happy in the certainty that I was created to be happy, not only in the other world but also in this one.
4. Only for today, I will adapt to circumstances, without requiring all circumstances to be adapted to my own wishes.
5. Only for today, I will devote 10 minutes of my time to some good reading, remembering that just as food is necessary to the life of the body, so good reading is necessary to the life of the soul.
6. Only for today, I will do one good deed and not tell anyone about it.
7. Only for today, I will do at least one thing I do not like doing; and if my feelings are hurt, I will make sure that no one notices.
8. Only for today, I will make a plan for myself: I may not follow it to the letter, but I will make it. And I will be on guard against two evils: hastiness and indecision.
9. Only for today, I will firmly believe, despite appearances, that the good Providence of God cares for me as no one else who exists in this world.
10. Only for today, I will have no fears. In particular, I will not be afraid to enjoy what is beautiful and to believe in goodness. Indeed, for 12 hours I can certainly do what might cause me consternation were I to believe I had to do it all my life.
The Importance of Staying In the Moment
In practical terms, those with the disease and those without it seem to understand that the slogan One Day at a Time is all about calming one’s self down long enough to do the next right thing. It’s about staying in the moment so that you don’t give yourself time to be overwhelmed by the future.
Michael B.*, an Edgewood counsellor with 30 years in Al-Anon and another 28 in A.A., has been counselling people with addiction for 26 years. “One Day at a Time really just breaks it down. I can get overwhelmed when I think about the future. Crazy making. I want to control it. Run it. Panic about it. My anxiety goes up through the roof. But when I just stay in one day at a time, I can manage that.”
He also recommends taking it deeper, if necessary.
“Sometimes I break it down even more to just this hour. Or the next five minutes. So, it helps break things down to manageable segments, a manageable load.”
“Life gets real. We try to solve the problems of the future. So, that’s when we start learning to take responsibility just for today. To stay in the moment.” – Sergio O.
One day at a Time is a philosophy and counsel that can be applied by people with any kind of addiction, their family members, as well as people without an addiction. The overwhelmed, anxious moments all humans face can be eased with getting grounded, and this slogan provides that relief.
“Is it common for addicts to feel overwhelmed? Oh yeah. Incredibly. It crosses all forms of how addiction acts out. Addicts and alcoholics, myself included, we are so used to having to manage and control and figure out and second guess.
‘So, being able to just breathe and figure out what’s the next right thing, instead of two weeks from now, what’s the healthy thing that I can do right now? It makes all the difference in the world.”
EHN Canada Can Help You
If you would like to learn more about the addiction and mental health treatment programs provided by EHN Canada, enroll yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
- 1-866-860-8302 for virtual outpatient support, available wherever you are
*Name has been changed
The Importance of Hope in Addiction Recovery
By George Ratnanather. Updated January 6, 2021.
Recovering from an addiction is a complex process. The road is never smooth. In fact, you will probably encounter obstacles, hardships and heartaches. But it’s a journey that everyone hoping to recover from addiction must make. It is the only way to move from a life of destruction to life of health, wellness and joy.
While there are many paths to recovery, there is one element that is constant–and that’s hope. But why is hope so important in recovery?
The Importance of Hope in Recovery
Hope is more than mere wishful thinking; it is the bedrock upon which you build your recovery. Without hope, or a desire to recover, there would be no motivation to get better. With no motivation, there would be very little meaningful action. Finally, with proper action comes improvement through a series of steps leading to a plan for recovery, and working the plan for years to come. I cannot stress harder the significance of hope in recovery.
What is ‘hope’?
Each of us defines hope differently. But in essence, hope is the expectation that things in the future will be better; knowing that the sun will shine again.
Relating to addiction recovery, hope becomes a foundation and the energy that drives us to find a way to get better and heal. It keeps us strong when we encounter challenges. And hope gives us a sense of joy and peace, knowing that a better tomorrow exists.
When preoccupied in an addictive substance or behaviour, it not always easy to see a life beyond the addiction; beyond the chaos, pain and suffering. But hope can be found. There is no right or wrong way to find hope. Sometimes it comes easy, and sometimes we need to work to find hope.
Below are a few ways that have helped our clients find hope even during times of deep despair.
Listen to Stories of Hope
Hearing stories of hope, success and triumphs of others can help us find hope. These stories not only inspire us, but also shed light on strategies of finding and sustaining hope even during the darkest times. We try to share as many stories of hope on our blog, but there are so many sources to discover online: on blogs, social media (like Instagram, Facebook, Pinterest), podcasts, etc. Finding someone you know or who speaks about their experience often can be really helpful to follow or bookmark for more regular inspiration!
Think of the Future
Look into the future and identify who and what is important to you. It could be a loved one, such as a child, spouse or parent. It can also be an event or something you always wanted to do. Looking into the future helps cultivate a purpose and direction in life (i.e. hope).
Though a simple process, positive affirmations do work. The repetition of positive affirmations leads to belief, and belief is at the heart of hope. Affirmations such as ‘I am strong, I can overcome my challenges, I am a new person, I feel new hope and I can recover’ rebuild a sense of self-worth and your belief that you are capable of achieving your goals. Not only do affirmations build belief, but also a confidence and a drive for change and action.
Leaning on a Higher Power
Many find hope by reaching for a higher power. This could be through spirituality, religion or philosophy. Reaching to a higher power is actually Step 2 in the 12-Step Process: “Came to believe that a power greater than ourselves could restore us to sanity”. Simplified, this reads as, ‘There is help for my problem and I believe I can address it’.
Accept Your Current Situation
For some, it may be hard to accept that they are currently in a bad place. But the courage of acceptance is the first step in desiring a better future (i.e hope). Acceptance helps us realize that our current situation is not where we want to be, and helps us develop a vision of where we want to be. Without acceptance, we cannot take control of our destiny to reach a better tomorrow.
Have Realistic and Meaningful Plan
It is action that makes hopes come true. By the mere fact of developing a plan for a better future, you will build hope. The more your plan has firm action steps and dates, the more successfully you will come to realize that your vision is truly attainable. If you’re working on a self-guided plan, try finding tools online like SMART goal setting or some tips to develop a successful recovery plan.
The journey and recovery from addiction is never an easy one. No one can last long and keep fighting for recovery without hope. Hope is a central ingredient in our recovery. Finding hope and meaning, together with a solid plan, helps us move forward on our journey of recovery.
“Everything that is done in the world is done by hope” – Martin Luther
EHN Canada Can Help You
If you would like to learn more about the addiction and mental health treatment programs provided by EHN Canada, enroll yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
EDGEWOOD TREATMENT CENTRE EXECUTIVE TAKES ADDICTION PERSONALLY
By Jeff Vircoe
She is the first one to admit she isn’t front and centre when it comes to fighting the disease. At least, not in the same way as are counselors and support staff.
Yet, behind the scenes, Colleen Ward has quietly created as big a footprint around the Edgewood campus as any staff member over the past 13 years.
As Edgewood’s Director of Operations for the past six years, Ward has been responsible for, amongst other things, keeping the treatment centre compliant and current inside the maze of British Columbia’s complex licensing laws. With a background in residential care facilities, including Director of a group home company for mentally and physically challenged adults, Ward arrived from the Lower Mainland in 2002. Born in Burnaby, raised in Surrey, she came to Vancouver Island for reasons related to addiction – though she wasn’t ready to see it. All she knew was that her father was dying.
Her two older siblings and their families had already moved to the Island to be closer to their dad when Colleen, her husband Frank, an RN, and their two young boys came to Nanaimo as their father battled a liver shut-down.
“He got really sick. They actually didn’t think he was going to pull through. They told him he couldn’t have another drink in his lifetime – he couldn’t even take Ibuprofen. Anything that went through his liver he couldn’t take.”
So, he quit drinking, but the damage was done.
“He lived two years. We got two years.”
Though just 64 when he passed away, Colleen’s father had been a daily drinker for as long as she could remember. Yet, it wasn’t until she started at Edgewood and, in particular, after completing the weeklong Family Insite program, that she realized addiction wasn’t a minor detail in her upbringing.
“I actually didn’t know that I was in an alcoholic home. I just thought it was normal. I didn’t know people didn’t come home from work and have a bottle of rum,” she said.
“We never called my dad an alcoholic. We knew my dad drank a lot, but I pictured alcoholism as what you saw on TV and movies. Where you’d come home and your dad would be mean and abusive. That kind of stuff. I didn’t grow up that way. I was spoiled with family vacations, a dad who came and watched all my sports, nightly family meals, and I was taught a good hard work ethic. But, I grew up knowing that sometimes I’d come home and I’d have conversations with my dad that I would have to repeat the next day because he would have been too drunk to remember.”
For years, her father held a powerful position as the general manager in the Port of Vancouver.
“He was a functioning alcoholic,” says Ward. “He held a great big job. He went to work every day. And because he worked downtown in the Port of Vancouver, we used to go down and see him at work and we would see the drunk people on the streets downtown on Hastings. That was an alcoholic to me. Not because you drank a bottle of rum and didn’t remember things.”
Ward recalls how, during her interview process with Edgewood, she was asked if there was any addiction in her family. She said no, just on her husband’s side. After competing Insite, she knew differently.
“Us as kids, not putting it together, I didn’t know how alcoholism actually affected the body. I didn’t know that it … I mean you hear of cirrhosis but you don’t know that it actually kills the veins, and the veins can actually detach from the liver. That’s what he died of.”
“I came back after and said to [Executive Director] Lorne Hildebrand that I had lied in my interview,” Ward recalls. “I mean, I didn’t lie, but I’d never said that about my dad before out loud. In Insite, it was the first time I actually used those words, that I had grown up in an alcoholic home.”
With Edgewood having a staff of 150 full- and part-time employees these days, Ward is responsible for the day to day, non-clinical operations, while Elizabeth Loudon looks after the clinical side of things. So, like any multi-million-dollar business, behind the scenes, Ward is overseeing staffing issues, standards and licensing concerns, accounting, marketing and more, with a myriad of people, places and things to cover throughout the building.
Like most of the people who staff the halls in the House of Miracles, as Edgewood is frequently called by its alumni, Ward’s job description today has come a long way from where it began. But, like many staffers, it was in the early shifts that she began to realize how powerfully impactful on a personal level the job can be.
“The first two weeks, they put me at the front desk nurses’ station. I remember there was this older gentleman that was admitted and he looked horrible. He was so sick. That reminded me of my old patients at the group home. But, within a month of him being here, he looked so much better.
Soon after she did the Insite program, among her peers was the man’s wife.
“I made this connection. Hearing his side of the story from talking to him. Then going through Insite and hearing his wife’s side of the story. Then knowing they were so looking forward to being a family again and him being sober.”
Unfortunately, the man died soon after treatment of a heart attack, introducing Ward to another aspect of life in the trenches at a treatment centre. It can be heartbreaking.
“Still, you know they got this little window, and even though it was only a little window they got this sort of closure,” she says.
Starting as executive assistant to the leadership team at the time, Ward says the learning curve was steep but so was the progress of her career.COLLEEN EMCEES THE ANNUAL EDGEWOOD RUN FOR ADDICTION AWARENESS.
“Well, I started by assisting them. They really didn’t know what they needed. They knew I had the policies and procedures piece. They knew from my resume that I had the CARF (Commission on the Accreditation of Rehabilitation Facilities) training. So, my job really started to develop because I had already run a residential facility. I understood the licensing aspects, how to keep a facility licensed. I understood staffing issues and HR issues. So, they just started giving me more and more as each of them retired. Finally, I had taken over all administration and I sort of took over more of the staffing for accounting. I just sort of ended up with everything.”
While counselors counsel, support staff support, cooks cook and maintenance workers maintain the property, Ward has come to understand how everybody who works at Edgewood has an integral role in offering hope to the addict who comes looking for life-saving help.
“Even though I’m not often on the floor with the patients, I know, when I write a policy and it has to be followed, it is for the best reasons for the patients. I’m always into different stuff. Even though I don’t do the heavy lifting with the patients, I know that I make a difference because this facility runs pretty seamlessly. A big part of that is structure.”
Like any good leader, Ward is quick to give credit where credit is due. She explains that there is no way a facility like Edgewood can demand as much from its patients without a complete buy-in from the staff. It is important, she notes, that staff realize they cannot expect patients to do anything staff is not willing to mirror.
“We are so open and honest to look at ourselves before pointing fingers. I love that we are willing to call each other on our own stuff and fight it through and be that big dysfunctional family, but then go back out and call the patients on their stuff, too. It’s fulfilling for me.”
Feedback is one of those aspects of employment at Edgewood that becomes quite personal.
“For sure. I used to be the type of person where, if you give me feedback, I’d be, ‘No but …’ or ‘Yeah but …’ [laughs] But, now, I’ve sort of stopped and even worked it into my family life raising my kids. I can tell my kids something and they will argue with me, and I just wait it out. Wait until they can hear me. I will give them the feedback. They don’t always take it. I can let that go. I’ve done what I have to do. I can live with that.”
Clearly, Ward is not one to apologize for the rigorous honesty demanded of staff who choose to work at Edgewood. Lives depend on those high standards.
“I think, as a treatment centre in this country, we are pretty important because I think we are where everybody wants to get to. We can offer people what they are trying to get to. Abstinence,” she says, wading into a delicate topic.
“Yes, there is a start. I’m not against harm reduction. If that’s where you have to start, that’s okay. But I believe that everybody can get to abstinence. I don’t think you have to live your life on maintenance. I think there is a way to walk you straight to the end, and abstinence would be that way. So, that’s why I think we are the best. We get you to the goal. When I hear people [saying] that, 20 years later, they are still sober, they are still doing the stuff we told them to do, they still trust us, they are still making their beds. We are what you want to get to. We offer people what they want to get to.”
Those who make it in the field are those who are uncompromising in their commitment to help people overcome this most devastating of illnesses. And there is one principle above all that is needed if you want to last while helping others. Compassion.
“You either love it or you hate it. If you love it, you can see the hope that we are giving. And, if you hate it, you can only see the devastation that addiction has caused. I can see the differences we make every day. I think you may be in a little bit of denial yourself if you’ve hated it here. You won’t take a look at yourself strongly. And you just don’t understand addiction. You just don’t get it. And I think that’s okay. I don’t think everybody is ready to look at addiction [and] the way that it affects their life.”
So, for Ward, she puts on her hardhat every day and fights the good fight. Roll up the sleeves. Be truthful. Treat everybody equally. And expect the unexpected.
“Some days I love it. Some days, not so much,” she says.
“There’s always one patient I seem to remember. And when you lose one, it’s just so sad. It’s devastating how it affects the community. The whole community that we have created here. I have a soft spot for some,” she says.
“Recently, we brought a patient in here who was very street-entrenched, tough. But this is what he wanted. Someone to talk to. He wanted a community. That’s what I felt we could give him here. So, he, [along with everyone who has been through here], has the whole alumni community that we have built here in Nanaimo – and wherever they move to after they’ve come through Edgewood. Not everybody has a family that they can talk to, but we create that for them here.”
Alumnus Celebrates A Decade of Recovery
My name is Judy P. and I was an inpatient at Edgewood during October, November and December, 2007. I also returned the following year for a week of Insite.
I am coming up on my 10-year anniversary of being clean and sober. At 62 years old, I am very happy about this and will mark the occasion in style, I am sure.
My path to become an Edgewood alumnus has been interesting to say the least. I owe much of it to a remarkable woman — my best friend.
In 2007, Kathe, who is now 38 years sober, took me out for dinner one evening and suggested, in a very kind way, that perhaps I was drinking too much. She pointed out that I had told her on a previous occasion I was probably drinking too much wine. It did not go over well. I sat in heated silence, seething with anger, basically wriggling in my seat with zero witty come backs. I went home. I did not speak to her for a couple of weeks. Unfortunately, whether I agreed with her or not was not the point. The point was that I could not get her words out of my head.
Kathe truly wrecked drinking for me. I would pour myself a glass of wine in my crystal goblet, take a sip, and her words just kept echoing in my mind, my internal committee debating their merit.
“Do I drink too much?” Well, sure, but so what?
“If you had been through what I’ve been through, you would drink too.”
I even had a therapist and a GP that counseled me. I was told, “Your problem isn’t drinking, your problem is your relationship,” or, “You need to get rid of him.”
I am including this because well-meaning health professionals are not necessarily trained nor do they know a great deal about alcohol abuse. I was having a very hard time admitting I was an alcoholic. I went around and around with that but, in the end, I decided that I just wanted to stop drinking and if that made me an alcoholic, then, fine, I was an alcoholic.
Kathe gave me the Big Book to read. I phoned her one evening after drinking several glasses of wine. She asked me what I thought of the book. I told her I thought it was stupid and had nothing to do with me.
After waking up another morning, feeling hung over and absolutely wretched and driving my son to school, I finally decided I was sick and tired of being sick and tired. I emailed Kathe and said I was ready. She was amazing! She booked me into Edgewood. She tried Betty Ford first, but when she told them it was for a friend, the receptionist kept telling her, “It’s alright dear, you can tell me it’s really for you. People do it all the time.” She hung up and called Edgewood. She offered to look after my son for the duration of my stay.
To me, Kathe is the embodiment of all that is good and wonderful about A.A., an amazing human being with whom I count myself extremely fortunate to be friends. She wasn’t just kind and caring. She was knowledgeable and effective. She went with me to see a counselor in another town, and she flew with me to Nanaimo. She brought my son out to visit me. I owe my sobriety, and much more, to her. I was a mess, and she picked me up and put me exactly in the right place to get the help I needed. It doesn’t get any better than that. I will always be grateful to her for having the courage to call me out.
I signed into Edgewood on October 17, 2007, which is my anniversary. I left on December 14.
My memories? Well, my counselor was Dale Burke, who, along with the other staff, was incredible. I can remember very clearly how confused and upset I was when I showed up. I was so bewildered that I had actually checked myself into rehab, and I questioned the wisdom of that decision daily for the first couple of weeks. I questioned Dale so much that she finally drew on a page in my binder for me to look at.
“Judy is an Alcoholic.”
I do remember having a hard time with all the rules. Not because I have authority issues, but because, as a mature business person with success under my belt, I was used to being the authority. I remember complaining to a friend on the phone during the second week, “They keep telling me what to do!”
She replied, “Why don’t you try doing what they tell you?”
Good grief. Apparently, not listening to what others tell me to do was not restricted to my drinking.
The Serenity Prayer also pissed me off immediately. My attitude was, well, maybe all you losers who have nothing better to do can be serene. This was said inside my head, but dripping with sarcasm. Seriously. Who has time for this stuff? I had places to go, people to see, and things to do – except I didn’t. I was stuck in that chair, in that auditorium, by my own admission.
Weeks later, while I was obsessing about my boyfriend, a peer said to me, “Oh, you have the codependent crazies.”
It stopped me dead in my tracks. There was a name for that? There was a condition that other people experience similar to the one I was feeling? That was my eureka moment. Far more than identifying with being like other alcoholics in treatment, it resonated, and I literally reverberated with that recognition. It was a huge turning point for me. The book Codependent No More and its sequel have both proven very influential.
I did not receive a chip when I left, as the counselors felt I still needed more time. However, I did attend aftercare groups for a year. I went to A.A. for 90 visits in 90 days and I got a sponsor. My aftercare plan suggestions continued for years, as did Big Book studies and my Insite stay at Edgewood.
Still, it was not a smooth transition. It was rough and bumpy, and I got in my own way at every conceivable step. Just trying to be honest with myself, let alone the rest of the world, was dicey. My mind was a whirling mass of anxiety spiked with rage, self-pity and blame. I was an equal-opportunity blamer, dumping as much on myself by excusing the bad behavior of others, and simultaneously spewing venom on the unchosen. Again, I was busy doing this inside my own head.
I clearly remember the first time I drowned out the raucous, nasty, noise in my head with gratitude. It seems the two are mutually exclusive. At least, for me they are. It gave me peace of mind. That was, and is, the most valuable thing I learned, or, at least, the one I came to rely on the most.
My biggest challenge in early recovery was an abusive relationship in which I was embroiled, of which I continued to reel in and out for my first few years before ending it for good seven years ago.
But, thanks to Edgewood, having another drink was not an issue. I stayed sober throughout it and have not had a drink since before checking into Edgewood. That relationship signified my rock bottom, and I needed to be living sober long enough to realize my self-worth. Once I got out of the relationship, I felt truly free.
Going to Edgewood and A.A. gave me the tools to do that.
These days, I am retired, happily remarried and living in Pennsylvania. My husband, an anesthesiologist, is a wonderful man — intelligent, kind-hearted and the owner of a great sense of humor. Living on 150 acres in the country with a flowing stream, we are about 90 miles from New York City. Our quiet life is punctuated with trips into the city to see a play or shop, and lots of travel. Life is very good.
I have one son. He came to visit me in Edgewood one family day. If you ask him about my drinking, he will tell you he only ever saw me drunk maybe twice. I simply did not drink around him. He did, however, suffer through the rollercoaster of emotional upheaval and the chaos of the effects of my drinking and being involved in an abusive relationship. We have talked about this many times and I have made amends; he assures me that all is well. Thank God. He is now 23 and has just graduated with his Masters Degree. He went through university at a prestigious post-graduate school on scholastic scholarships, and, if I was any prouder of him my head would explode. He is kind and big-hearted, and I love him to bits.
In closing, I hope my story can be of some use to our extended family of Edgewood alumni. Over the years, I have recommended Edgewood to several people. It was an amazing experience. Ten years later, I am still very grateful for having had the opportunity to get sober and turn my life around in such a supportive, caring place.
The therapeutic value of Keep It Simple
By Jeff Vircoe
The Akron surgeon probably knew the therapeutic value of the term as well as anyone.
But when Dr. Robert Smith offered Keep It Simple as prescription for the good health of one Bill Wilson, he probably had no idea how profound that little slogan would become.
Keep It Simple was one of the most frequently used slogans by Dr. Bob. On record, he offered it up on the railway platform when Bill left Akron to return home to New York after the summer of 1935. He used it again during his last talk to the membership at the 1950 Alcoholics Anonymous International Convention in Cleveland. And, he encouraged Wilson to pay attention to the simplicity message the last time the two cofounders of A.A. spent time together, just weeks before Dr. Bob died in November 1950.
Sixty seven years later, in countless meeting rooms around the globe and in thousands of treatment centres like Edgewood in Nanaimo, B.C. (part of the Edgewood Health Network) the slogan Keep It Simple is still considered a fundamental slice of the recovery pie.
Apparently, addicts need that simplicity. It makes sense.
“Drug addiction is a complex illness,” reads the first page on the National Institute on Drug Abuse (NIDA) website.
As one of the world’s leading researchers into the health aspects of drug abuse and addiction, NIDA is about as scientific in its definitions and vocabulary as any organization. Its credibility is impeccable. With articles on diagnostic methods, pharmacology, and use of heady terms like endogenous and cardiac arrhythmias, organizations like NIDA help scientists and doctors, treatment centre counselors, and you and I to figure out the mechanics of what is wrong and what is fixable with our brains. Yet, with scientific language about as exciting as watching grass grow, it’s not exactly Keeping It Simple. So, by telling readers that, first and foremost, “drug addiction is a complex illness,” NIDA’s intro speaks volumes.
If drug addiction is a complex illness, it probably goes without saying that addicts are complex people. But are they?
Not necessarily so, says one woman with a decade of working with and studying addicts.
“I believe there is not a huge difference, sometimes, between the life problems that addicts face and the life problems that somebody without active addiction faces,” says Dr. Christina Basedow. “One of the main differences that I see is the amount of obsession that is given to those types of problems. So I wouldn’t say that addicts necessarily complicate things, but I think the obsession that comes as part of addiction complicates things.”
With a PhD in Psychology, Basedow is the supervisor of the continuing care team at Edgewood Treatment Centre in Nanaimo. Her team of counselors treats patients in extended care – a typically three-month phase of treatment which follows two months of inpatient residential treatment. In extended care, patients continue with the group therapy in which they’ve been extensively involved in inpatient treatment. But, they are also transitioning back into work or school, volunteering, and attending 12 Step meetings in the community. It’s a transition back to the outside life awaiting them: bills, relationships, jobs, kids and health issues. You know – life. Everyone’s got problems, and everyone has their own way of navigating through them. But, by the sheer nature of addiction, the level of obsessiveness with which addicts roll into recovery makes dealing with life, well, complicated.
“There’s a belief that addicts think that ‘normal’ people don’t have all of these [life] issues,” says Basedow, “and they think, ‘There is something wrong with me – there’s something different and I’m sick.’ But, really, it’s not that ‘normal’ people don’t have issues. It’s just that they don’t obsess to the nth degree about them.”
With a decade of experience studying and helping addicts, Basedow explains how the addict can’t necessarily help him- or herself when it comes to how they process information.
“Addiction has definitely got a brain disorder component. We’ve seen that. If you look at it from a hereditary perspective or a thought process perspective, the cognitive distortion perspective, there’s definitely something that’s dysregulated in the brain when it comes to active addiction, especially when someone is using. It can re-regulate when we get into recovery. But, in the active phases of addiction, there is absolutely a cognitive dissonance component and a brain component to it.”
The idea of interfering in the crazy-making, obsessive, compulsive mind of an addict means hope is available, but it requires a complete overhaul of how addicts approach their lives. A rerouting of the brain patterns and responses to issues. The 12 Step movement offers one way. Psychotherapy offers a way. Medication management, diet and exercise, pet therapy, religious programs – many suggested avenues appear on the map toward recovery.
At Edgewood, what has been found to be successful is taking an honest inventory of what has been going on in active addiction, studying the story told by the addict brain and comparing it to the facts. So, a lot of time is spent on assignments like Step One, and on questions like how have chemicals placed your life or lives of others in jeopardy? Have you lost self respect due to chemical usage? What is it about your behavior that your spouse-friends-family object to the most? Questions like these, truthfully answered, can start the process of rewiring the complicated web of half-truths, full on lies, or imaginary instances with which many addicts have been living in their un-simple world.
Dr. Basedow says the assignments and plenty of group therapy are about getting to the truth and changing the story.
“It’s about sorting out what the story is that this person has been telling themselves sometimes from childhood onward, what has kept the lies alive, what has kept them disassociating or kept them complicated or kept them using. Re-narrating the story into something that’s a lot more simplistic. It could be something as simple as, ‘I had a lot of stuff happen in my childhood, and some of them were really traumatic. And, because of that, I didn’t connect with people. And, because of that, I told myself that I was unworthy and unlovable. And, because of that, I was …’ It’s about asking, ‘How do I re-narrate all of these thoughts that I’ve had into a story line that has led me to use?’”
“That’s why we use group therapy, because, then, more people than just one can help re-narrate the story and confront the masks you wear and the different types of stories you’ve created for yourself and the way that you keep yourself away from people. And, just the lies you’ve told yourself, whether it’s the victim stance or whether it’s a different type of role.”
Once the honesty aspect – the truth about our situation – is established within us and with others, then recovery can grow from a spark into a life filled with ups and downs.
Keep It Simple means understanding that life is not always up or down.
“When you get into recovery, everything feels different. You’re not using a substance of process or choice. And because you’ve used it to regulate your emotions for so long, you don’t know that this flood of emotions, this roller coaster, is a normal part of early recovery, and the problems that people in early recovery are facing are not abnormal. People out there [who] don’t have substance abuse issues are also struggling with things and also don’t know how to cope. They just don’t pick up [an addiction] to get through them,” says Basedow.
Perhaps no item provided by Edgewood staff to patients is as useful as the Aftercare Plan. A one-page document which describes in simple detail a list of items to follow each day to maintain the spark of recovery embedded in treatment, the Aftercare Plan keeps things in a simple order.
Meetings. Sponsorship. A home group. Aftercare. Exercises to look after physical, spiritual and mental health. Nothing too complicated, the Aftercare Plan is Keep It Simple in action.
The willingness to enact their plan is on the addict.
If you’ve spent money and time on feeding your addiction and it led you to a point of devastation and you or your loved ones chose to spend money and time getting help, including treatment at one of Canada’s most widely recognized centres, then Keep It Simple means carrying on the process of recovery, bumps and all.
“I think there is solid therapeutic value in Keep It Simple,” says Basedow. “Really, what we are saying in Keep It Simple is don’t trust your mental obsession. Don’t trust the constant reoccurring thoughts as your brain is rewiring itself. Don’t trust that all of those ideas are good. Don’t trust that [you] should act on every impulse. Don’t trust that [you] should re-engage with every person that [you] thought that maybe [you] shouldn’t have. Basically, don’t act on impulse is what keep it simple is all about. Keep it grounded. Keep it connected. That’s the whole purpose, really.”
Quand le sexe n’est plus source de plaisir
By Jeremy Hainsworth
In some people’s brains, this word can trigger a reaction similar to the words “cocaine” or “heroin”.
Indeed, for an addicted person seeking to neutralize their feelings, compulsive sexual behavior can be as attractive as any other form of consumption – alcohol, drugs, shopping, gambling, etc.
“Sex addiction doesn’t make you bad, kinky, or desperate. It means that you may have an illness or an obsession, which it is quite possible to cure, ”said Patrick Carnes, Ph. D., a pioneer in this field.
While the form of compulsive behavior differs from that of other addictions, the symptoms are essentially the same.
“This is compulsive behavior that manifests itself in sexual activities – the term ‘activities’ here encompasses obsessions, fantasies and other behaviors that people do not openly display,” explains Nelson Sacristan, counselor at the University. Edgewood Health Network (RSE) and Clinical Director of RSE Vancouver.
“Sexual addiction can result from trauma, from an inability to create intimacy or express one’s emotions, or from sexual behavior,” adds Sacristan. The root cause of this disorder is similar to that of chemical dependence. “
He also argues that many of the people who come for treatment these days grew up with the Internet and did not develop socially or learn to seduce, date or find a partner.
Online pornography, now easily accessible, can fill this void.
According to Sacristan, “outside of pornography, these people are not really addicted or obsessed with sex.”
Pornography can also be traumatic for young people, according to Tami VerHelst, vice president of the International Institute for Trauma and Addiction Professionals (IITAP) in the United States. Indeed, she says that this type of trauma can be added to the root causes of compulsive behavior.
- Sacristan adds that people struggling with compulsive sexual behavior sometimes use chemicals to increase the stimulation of pornography or to uninhibit themselves in other settings.
“They can go further and perform sexual acts that they would not normally dare to do,” he explains.
“They could, for example, say that it was because of alcohol or cocaine that they called in an ‘escort’.”
For others, the consumption of alcohol or chemicals increases the stimulation, especially that associated with pornography.
Some people also consume substances or food afterwards to deal with guilt or shame.
“One of the topics of interest for IITAP is the problem of concurrent addictions.”
Selon M. Sacristan, les comportements sexuels compulsifs activent les voies neurologiques de la dépendance de quatre façons.
Il y a tout d’abord l’activation par la stimulation ou l’engourdissement.
Deuxièmement, il y a les fantasmes ou l’obsession, lorsqu’une personne est troublée par une autre.
Selon les explications de M. Sacristan, ce n’est pas vraiment une question de sexe : ces personnes perçoivent mal la réalité, et il faut leur apprendre à bien l’évaluer.
« C’est surtout le fait qu’ils entretiennent ces pensées ou qu’ils fondent des espoirs sur la relation », ajoute-t-il.
Vient ensuite la privation, lorsque les gens sont des « anorexiques sexuels » : ils ne cherchent pas à établir des relations, ou peuvent être rebutés par le sexe. Ces personnes vivent parfois d’autres manques, et on peut, dans le cadre d’un traitement, explorer quels autres besoins de la personne ne sont pas satisfaits.
C’est pourquoi M. Sacristan et d’autres experts sont d’avis que le traitement de la dépendance sexuelle devrait être axé sur la guérison de la personne tout entière. Il faut donc veiller à ce que ceux qui offrent le traitement soient formés et qualifiés dans ce domaine et détiennent le titre de thérapeute agréé en dépendance sexuelle.
L’objectif du RSE est d’avoir de tels thérapeutes dans tous ses établissements afin de pouvoir offrir un traitement aux personnes qui en ont besoin.
- Sacristan précise que cette certification est offerte par l’IITAP.
D’après lui, les consultations sont compatibles avec les 12 étapes, mais elles ne s’inscrivent pas forcément dans un programme.
« On s’intéresse à la cause première du comportement, au passé de la personne et à l’effet qu’elle recherche », explique-t-il.
« Chez certaines personnes souffrant de dépression ou d’anxiété, un comportement sexuel obsessionnel-compulsif sert à s’engourdir. »
Cependant, les termes comme « dépendance sexuelle » et « dépendant(e) sexuel(le) » dérangent M. Sacristan, qui préfère l’expression « comportement sexuel compulsif ». Les autres termes sont, selon lui, connotés négativement et pourraient entraîner une stigmatisation.
« Je préfère parler de comportements plutôt que seulement qualifier une personne de “dépendante sexuelle”. »
Mais c’est son avis personnel.
Bien qu’elle ne soit pas clinicienne, Mme VerHelst affirme pour sa part que bon nombre de personnes sont tout à fait heureuses de pouvoir nommer leur trouble, de savoir qu’elles ne sont pas seules et qu’elles peuvent obtenir de l’aide.
« Les gens aux prises avec ce trouble n’ont aucun problème avec le nom », affirme-t-elle, notant au passage qu’environ 40 000 personnes visitent chaque mois le site Web en anglais des sexomanes anonymes.
Au-delà de la terminologie, le concept a commencé à se cristalliser au début des années 1980 avec la parution du livre S’affranchir du secret de Patrick Carnes.
- Sacristan précise que M. Carnes, qui était alcoolique et dépendant sexuel, a mis sur pied une association au Minnesota et a fait connaître la notion de dépendance sexuelle.
« Il a conçu une approche de guérison fondée sur les 12 étapes et axée sur des tâches », explique Mme VerHelst.
Dans le cadre de ses travaux, M. Carnes a ciblé quatre phases et dix symptômes de la dépendance sexuelle.
Comme dans le cas d’autres comportements associés à la dépendance, les quatre phases sont l’obsession, la ritualisation, le comportement compulsif et le désespoir.
Les symptômes recensés par M. Carnes sont les suivants :
- Schémas de comportement hors de contrôle
- Conséquences graves découlant du comportement sexuel
- Incapacité d’arrêter malgré les conséquences indésirables
- Recherche persistante de comportements autodestructeurs ou très risqués
- Désir ou efforts continus pour restreindre le comportement sexuel
- Obsessions ou fantasmes sexuels comme principale stratégie d’adaptation
- Nombre croissant d’expériences sexuelles (puisque le niveau actuel ne suffit plus)
- Changements d’humeur importants en lien avec les activités sexuelles
- Temps excessif passé à rechercher et à vivre des expériences sexuelles ou à s’en remettre
- Désengagement par rapport à des activités sociales, professionnelles ou récréatives importantes attribuable au comportement sexuel
L’ouvrage S’affranchir du secret est venu asseoir la réputation de M. Carnes en tant que visionnaire dans le domaine, et d’autres intervenants du milieu de la dépendance ont commencé à lui emboîter le pas.
Il est alors devenu évident que des normes de formation et une certification étaient nécessaires pour le traitement des comportements sexuels compulsifs.
C’est ainsi que le programme de certification des thérapeutes agréés en dépendance sexuelle a vu le jour.
Le programme de l’IITAP est fondé sur des études théoriques, des formations pratiques, de la supervision et l’acquisition de compétences d’évaluation.
Selon Mme VerHelst, l’objectif du traitement de la dépendance sexuelle est d’aider les gens à délaisser leurs comportements destructeurs pour pouvoir accéder à une vie heureuse et productive. Pour cela, il faut d’abord déterminer si une personne souffre bel et bien de ce trouble.
C’est ici que le questionnaire PATHOS, un outil de dépistage de la dépendance sexuelle en six questions, entre en jeu. Voici les questions posées :
- Êtes-vous souvent préoccupé par des pensées de nature sexuelle?
- Dissimulez-vous certains de vos comportements sexuels?
- Avez-vous déjà sollicité de l’aide en lien avec un comportement sexuel que vous n’aimiez pas?
- Votre comportement sexuel a-t-il déjà blessé quelqu’un sur le plan émotionnel?
- Avez-vous l’impression que votre désir sexuel a le contrôle sur vous?
- Vous sentez-vous déprimé après une relation sexuelle?
Si la personne répond « oui » à au moins une question, Mme VerHelst recommande d’obtenir de l’aide.
Elle mentionne également le test de dépistage de la dépendance sexuelle, conçu pour évaluer un comportement sexuel compulsif et déterminer s’il y a dépendance sexuelle.
Toujours selon Mme VerHelst, le site Web www.sexhelp.com est un autre outil précieux pour les personnes qui se questionnent pour la première fois sur leur comportement ou celui d’un autre.
Selon M. Sacristan, une fois que la personne a exprimé des préoccupations ou qu’on a mis en évidence chez elle un comportement sexuel compulsif dans le cadre d’une consultation ou d’un autre traitement, on peut commencer le travail.
Mme VerHelst explique que le traitement par un thérapeute certifié repose sur une « recette de guérison » constituée de 30 tâches.
Grâce au travail que le conseiller effectue avec son client, il est possible de mettre en lumière des blessures profondes à l’origine des comportements négatifs.
Les outils utilisés par les thérapeutes pour aider leurs clients incluent un inventaire de la dépendance sexuelle, un inventaire du stress post-traumatique, un programme axé sur le travail et la rémunération et des évaluations pour les partenaires.
Selon Mme VerHelst, on compte actuellement 1 700 thérapeutes certifiés dans le monde.
« Même s’il y en avait cinq fois plus, ce serait toujours insuffisant », ajoute-t-elle.
Cependant, comme le souligne Mme VerHelst, la notion de dépendance sexuelle n’est pas acceptée de tous.
En effet, les débats sur son existence sont tels que bien qu’il ait été ajouté à la 3e édition du Manuel diagnostique et statistique des troubles mentaux (DSM-III) de l’American Psychiatric Association, ce trouble a été retiré du DSM-V.
Elle explique que le mouvement de libération des femmes dans les années 1970 rejetait cette idée, et que l’industrie de la pornographie est résolument opposée au concept de dépendance sexuelle.
« Leur raison de s’y opposer vaut plusieurs milliards de dollars », ajoute-t-elle.
« Il y a eu beaucoup de manœuvres politiques. »
« On continue malgré tout de former des conseillers pour aller de l’avant et répondre aux besoins », indique-t-elle.
- Sacristan tient à souligner que le traitement n’exige pas des gens qu’ils cessent d’avoir des relations sexuelles.
« L’abstinence n’est pas notre objectif, précise-t-il. Nous voulons que les gens soient en mesure de fonctionner. »
Des thérapeutes certifiés en dépendance sexuelle dans tout le Réseau Santé Edgewood
L’objectif des séances qui se dérouleront au Centre de traitement Edgewood de Nanaimo, du 5 au 9 avril et du 23 au 27 août prochains, consiste à former davantage de conseillers canadiens pour répondre aux besoins des personnes aux prises avec un comportement sexuel compulsif ou obsessionnel.
Cette formation pour devenir thérapeute certifié en dépendance sexuelle donne aux conseillers les outils pour reconnaître les comportements sexuels compulsifs et aider ceux qui en souffrent à retrouver leur capacité à vivre une vie heureuse et normale.
Les deux premiers des quatre modules seront offerts au Centre de traitement Edgewood, mais la formation elle-même sera donnée par l’International Institute for Trauma and Addiction (IITAP) des États-Unis.
La directrice clinique d’Edgewood, Elizabeth Loudon, estime que les séances attireront entre 30 et 50 personnes de partout en Amérique du Nord.
Mme Loudon vient d’ailleurs de terminer un volet de sa formation auprès de l’IITAP.
Selon elle, il ne fait aucun doute que les thérapeutes canadiens devraient avoir davantage accès à cette formation.
« Je suis vraiment heureuse de faire partie de ce mouvement d’apprentissage et suis très fière qu’Edgewood y participe », se réjouit Mme Loudon.
La vice-présidente de l’IITAP, Mme Tami VerHelst, est emballée par le fait qu’Edgewood cherche à former davantage de thérapeutes certifiés en dépendance sexuelle au Canada.
« Le besoin est réel. Nous espérons que nous arriverons à mobiliser un grand nombre de Canadiens. »
D’après elle, à l’heure actuelle, de nombreux Canadiens qui pourraient avoir besoin d’un traitement pour une dépendance sexuelle doivent voyager plusieurs heures pour obtenir de l’aide.
« Avec davantage de formations comme celles offertes à Nanaimo, nous pourrons aider plus de Canadiens à gérer un comportement sexuel compulsif », ajoute-t-elle.
« Mme VerHelst sait à quel point notre travail nous tient à cœur », mentionne Mme Loudon.
According to her, some participants will be able to stay in the rooms on site and enjoy the campus, while others can be accommodated outside the site.
Click here to learn more about the IITAP Sex Addiction Modules to be offered at the Edgewood Treatment Center in Nanaimo, British Columbia .
Dix faits importants sur les troubles de l’alimentation au Canada
Croyez-vous que les troubles de l’alimentation sont un problème de santé majeur au Canada? Eh bien, sachez que ce type de trouble affecte un plus grand nombre de Canadiens que vous le croyez. Selon le National Eating Disorder Information Centre (NEDIC), les troubles de l’alimentation touchent en tout temps un million de personnes. Cela dit, une étude récente du NEDIC a révélé qu’une personne sur deux souffrait ou avait déjà souffert d’un trouble de l’alimentation, ou connaissait quelqu’un qui en souffrait ou en avait déjà souffert. Il existe une énorme différence entre l’IDÉE que se font les gens des troubles de l’alimentation et la réalité.
Il va sans dire que davantage de recherches devront être consacrées aux troubles de l’alimentation pour que l’on comprenne mieux comment les traiter. Quelques études nous ont néanmoins aidés à recenser plusieurs facteurs pouvant contribuer à l’apparition et à la gravité de ces troubles.
Qu’est-ce qu’un trouble de l’alimentation? À quel point cette maladie mentale est-elle répandue en Amérique du Nord? Voici, en bref, dix faits importants qui vous aideront à comprendre leur ampleur RÉELLE :
- Les troubles de l’alimentation ne découlent PAS de l’obsession de la minceur véhiculée par les médias de masse. Ce sont plutôt des maladies mentales pouvant être associées à des facteurs génétiques, biologiques et environnementaux.
- Les troubles de l’alimentation ne touchent pas seulement les femmes : selon une étude sur la boulimie publiée dans l’American Journal of Psychiatry, entre 10 et 15 % des hommes en souffriraient.
- Les troubles de l’alimentation s’accompagnent souvent d’un problème de consommation ou d’un autre trouble psychiatrique tel que la dépression.
- Les personnes boulimiques sont plus susceptibles d’avoir subi des sévices physiques ou sexuels durant l’enfance.
- L’hyperphagie boulimique touche plus d’hommes et de femmes que l’anorexie et la boulimie combinées.
- Les athlètes – hommes et femmes – courent un risque plus élevé de développer un trouble de l’alimentation que les non-athlètes.
- Le nombre de jeunes filles hospitalisées en raison d’un trouble de l’alimentation a augmenté de 42 % au cours des deux dernières années, et le système de santé canadien NE SUFFIT PLUS à la demande!
- En l’absence d’un traitement adéquat, les troubles de l’alimentation peuvent être mortels. D’ailleurs l’anorexie mentale est actuellement la maladie mentale la plus meurtrière.
- Une intervention précoce peut tout changer : plus une personne souffrant d’un trouble de l’alimentation est traitée rapidement, plus elle est susceptible de se rétablir sur les plans physique et émotionnel.
- Au Canada, il y a trop peu d’études, de ressources pertinentes et de programmes de traitement accessibles pour aider davantage de personnes à guérir d’un trouble de l’alimentation.
Au Canada, les traitements et le soutien concernant les troubles de l’alimentation se font rares. La clinique Waterstone est une clinique de premier plan axée sur les troubles de l’alimentation. Elle propose des programmes de traitement de l’anorexie mentale, de la boulimie et de l’hyperphagie boulimique reposant sur une combinaison unique alliant approches thérapeutiques, développement des compétences et accompagnement. Pour en savoir plus sur ces programmes, envoyez-nous un courriel ou téléphonez au 416 495‑0926. Ensemble, nous pouvons redonner un sens à votre vie.
When Sex Is No Longer Fun
By Jeremy Hainsworth
It’s a word that can light up part of some peoples’ brains the same way mentioning cocaine or heroin might.
Indeed, a compulsive sexual behavior can be just as alluring for the addict trying to numb feelings as any other form off using – be that alcohol, chemical, shopping, gambling or any other form.
“Knowing you are a sex addict doesn’t mean you are bad or perverted or hopeless. It means you may have a disease, an obsession from which many have healed,” Dr. Patrick Carnes, a pioneer in the field, once said.
While the form of using may be different from other addictive behaviors, the symptoms are essentially the same.
“It’s a compulsive behavior expressed in sexual activity although activity can be considered obsession, fantasy of course, other things people might do that may not be a behavior you can see outwardly,” said Nelson Sacristan, an Edgewood Healthcare Network (EHN) counselor and clinical manager of EHN Vancouver.
“At its root would be trauma, an inability to have intimacy, expressing emotions, sexual behavior,” Sacristan said. “The root of it is similar to chemical addiction.”
More recently, he said, people coming into treatment may have grown up with the Internet and haven’t socially matured or learned how to court or date and acquire a partner.
And now, readily available online pornography may fill that void.
“They’re not truly addicted to sex or compulsively with sex outside of pornography,” Sacristan says.
Porn could also be traumatizing to young people, according to the vice president of U.S.-based International Institute for Trauma and Addiction Professionals (IITAP). Tami VerHelst says that trauma could add to the roots of a person’s addictive behaviors.
Sacristan added that a person with compulsive sexual behavior might also use chemicals to enhance the stimulation of porn or to disinhibit them for other behavior.
“It allows them to go forward and do something sexually they might not otherwise do,” he said.
“They maybe might say it was because I was drinking or using cocaine that I picked up an escort.”
For others, the alcohol or chemical usage might enhance stimulation, including that from porn.
And, some might use substances or food afterwards to deal with the guilt or shame of what they have done.
“One of the emphases in IITAP was addiction interaction disorder,” he said.
Sacristan said there are four ways that addiction neuropaths in the brain are activated through sexually compulsive behavior.
First, there is activation through stimulation or numbing.
Then, there are those who might fantasy, obsession or intrigue with a person.
It’s not so much about sex, Sacristan explained. He said such people don’t have a good check on reality and need to be shown how to test that.
“It’s more around having the thoughts or wishing for the relationship,” he said.
Then, there’s deprivation, people who are “sexual anorexic.’ They don’t seek relationships or may be turned off by sex. Such people might have other deprivations and treatment can look at what other needs aren’t being met.
As such, say Sacristan and other experts, sex addiction should be treated in such a way for the person as a whole to move into recovery, which means ensuring whoever is providing treatment is educated and qualified in the field, and has standing as a Certified Sex Addiction Therapist, or CSAT.
Across the EHN realm, the goal is to have CSAT-certified staff at all facilities, so the network can provide treatment where a need is identified.
Sacristan said IITAP provides that certification.
He said the counseling is 12-step friendly but not necessarily part of a program.
“It’s looking at the root of the behavior,” he said. “You kind of think of where the addict is coming from, what is the effect they are looking for.
“Some folks use obsessive compulsive sexual behavior basically like to numb out from life, having a lot of depression or anxiety.”
Terms such as “sex addiction” and “sex addict” do trouble Sacristan, however. He prefers the term “compulsive sexual behavior.” He believes the other terms are loaded and could lead to stigmatization.
“I’d rather talk about the behavior than just say, ‘Okay, you’re a sex addict.’”
But that’s a personal choice.
Though not a clinician herself, for her part, VerHelst says many people are just as happy to have a name associated with the condition, to know they’re not alone, that they can receive help.
“The people with this issue don’t have a problem with the label,” she said, noting some 40,000 per month visit the Sex Addicts Anonymous website.
Whatever the terminology, the concept first began to crystalize in the early Eighties with the publication of Dr. Patrick Carnes’ book Out of the Shadows.
Sacristan said Carnes, an alcoholic and sex addict started a fellowship in Minnesota and “put the idea of sex addiction on the map.”
“He created a task-centered approach for recovery that is based on the 12 steps,” VerHelst said.
Through his work, Carnes identified four phases and 10 symptoms of sex addiction.
Much like other forms of addictive behavior, the phases are: preoccupation, ritualization, compulsive sexual behavior and despair.
The symptoms, Carnes found, are:
- a pattern of out of control behavior;
- severe consequences due to sexual behavior;
- inability to stop despite adverse consequences;
- persistent pursuit of self-destructive or high-risk behavior;
- ongoing desire or effort to limit sexual behavior;
- sexual obsession and fantasy as a primary coping strategy;
- increasing amounts of sexual experience (because the current level of activity is no longer sufficient);
- severe mood changes around sexual activity;
- inordinate amounts of time spent in obtaining sex, being sexual, or recovering from sexual experience, and;
- neglect of important social, occupational, or recreational activities due to sexual behavior
Out of the Shadows cemented Carnes’ reputation as a thought leader in the field and others in the addiction field began to follow his lead.
That, however, led to the acknowledgment that there was a need for a training standard and that certification to treat those with compulsive sexual behavior was necessary.
That led to the creation of the Certified Sex Addiction Therapist, or CSAT program.
Through the creation of the IITAP, a certification program built around academic study, experiential training, supervision and assessment competence was born.
VerHelst said the goal of sex addiction therapy is to help people move past damaging behaviors and onto happy, productive lives. But, first she said, it’s important to discover if indeed a person is in need of help fro the condition.
And that’s where the six-point PATHOS questionnaire screening tool for sexual addiction comes in. The questions it asks are:
- Do you often find yourself preoccupied with sexual thoughts?
- Do you hide some of your sexual behavior from others?
- Have you ever-sought help for sexual behavior you did not like?
- Has anyone been hurt emotionally because of your sexual behavior?
- Do you feel controlled by your sexual desire?
- When you have sex, do you feel depressed afterwards?
VerHelst suggested if you answer ‘yes’ to one or more of the questions, seeking help might be a wise idea.
Another tool, she said, is the Sexual Addiction Screening Test designed to assess sexually compulsive behavior that indicates the presence of sex addiction.
And, VerHelst said, the www.sexhelp.com website is also an invaluable tool for those making their first foray into concerns for themselves or others.
So, once a person has some concerns or a sexually obsessive behavior is identified through other treatment or counseling, specific work on the issue can begin, Sacristan said.
VerHelst said CSAT treatment involves a 30-task “recipe for recovery.”
It’s work a counselor does with a client that can help uncover deeper wounds that have resulted in the negative behaviors.
Tools CSAT therapists have to assist clients include a sexual dependency inventory, post-traumatic stress inventory, a money and work program and assessments for partners.
VerHelst said there are currently 1,700 such therapists worldwide.
“If we had five times that, we would still be underserving,” she said.
But, VerHelst stressed, the concept to sexual addiction is not without its detractors.
Indeed, debate over its existence had led it to be included in the third edition American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-III) only to see it removed in the DSM-V.
She said the women’s liberation movement in the Seventies opposed the idea and that the pornography industry adamantly opposes the concept of sexual addiction.
“They have a multi-billion dollar reason for it not to be ‘a thing,’” she said.
“There was a lot of politicking,” she said.
Despite that, educating of counselors continues to move forward to address the need for treatment, VerHelst said.
Moreover, Sacristan stressed, treatment does not ask people to stop having sex.
“Abstinence is not the goal,” he said. “We want to get people to the point where they can function.”
Certified Sexual Addiction Therapists across the Edgewood Health Network
Getting more Canadian counselors trained to meet the demand for people with sexually compulsive or addictive behavior is the goal behind sessions being held at the Edgewood Health Network’s Nanaimo treatment centre April 5-9 and Aug. 23-27.
The Certified Sex Addiction Therapy (CSAT) training allows counselors to identify and help those with compulsive sexual behaviours that are impeding their ability to live happy, normal lives.
While Edgewood is hosting the training on the first two of the four CSAT modules,the education itself is being provided by U.S.-based International Institute for Trauma and Addiction (IITAP).
Edgewood clinical director Elizabeth Loudon said the sessions attract between 30 and 50 people from across North America.
Loudon has just completed part of her CSAT training through IITAP.
She said it was clear there was a need for more Canadian therapists to have access to the training.
“I’m really stoked to be part of a learning movement,” Loudon said. “I’m really proud to have Edgewood behind it.”
IITAP vice president Tami VerHelst is excited about Edgewood being more involved with training greater numbers of CSAT–trained therapists in Canada.
“The need is there,” she said. “We’re really hoping we can engage a lot of Canadians.”
Right now, she said, many Canadians who might need sex addiction therapy have to travel many hours to find help.
Greater training in Canada, and through education such as that in Nanaimo, will help more Canadians deal with compulsive sexual behavior, VerHelst said.
“She (Tami) knows how dedicated we are here,” Loudon said.
Loudon said some participants could stay in rooms at Edgewood and enjoy the campus experience while others would be accommodated offsite.
Click here to learn more about this IITAP (CSAT) module series in April hosted at the Edgewood Treatment Centre in Nanaimo, BC .
Faire tomber les préjugés : les troubles de l’alimentation toucheraient plus de femmes d’âge moyen qu’on le croyait précédemment
Admit it: when you hear the words anorexia or bulimia , most of the time you think of a teenage girl who goes without food or who stuffs herself before making herself vomit. Research and the media have always told us that eating disorders mostly affect young women. Yet a recent study in the UK revealed a more complex picture.
Eating disorders affect around three percent of women in their 40s and 50s, according to this new study from University College London, while other studies have estimated that nearly one in 100 women aged 15 to 30 have a diagnosis of eating disorder.
Of the 5,300 Britons aged 40 to 59 who participated, 15 percent had had an eating disorder, of which 3 percent had been in the past year. It is not uncommon for a person to struggle with a problem for several years before seeking help.
Eating Disorders: A Limitless Scourge
It appears that thousands of middle-aged women are secretly living with an eating disorder that arises after divorce, financial problems or bereavement during this period of their lives  . In the UK study, the most common problem was binge eating . Moreover, although many of these women had coped with an eating disorder for a long time, two in five had developed it rather late  . In short, this study shows that eating disorders are chronic mental illnesses that can develop long after adolescence.
Unfortunately, many of the participants admitted that it was the first time they had spoken about their problem. Why don’t they go and get help? Is our society so obsessed with diets and the perfect body that we fail to recognize a true eating disorder when it descends into a vicious cycle?
We spoke with Ann Kerr, Clinical Director of Waterstone Institution, in Toronto, which deals with eating disorders. Ann Kerr is a registered occupational therapist and has worked in mental health for over 30 years. We asked her what, in her experience, could cause an eating disorder in middle-aged women: “They can develop an eating disorder because of the changes in body shape that occur during this time, especially due to menopause and changes in the distribution of body fat. In addition, they are more concerned than before about their body image and feel more compelled to counter old age and the signs of aging. However, the most common cause remains the underlying issues with body image, weight or figure experienced throughout life. “
Also according to Ann Kerr, it is possible that middle-aged women avoid asking for help because they would rather control their weight and figure on their own rather than face the even more painful emotions at the origin. of their eating disorder. They may also see these disorders as a problem for adolescent girls.
Stigma can influence the diagnosis of eating disorders: for example, men often suffer in silence. Indeed, for a man, suffering from a mental illness often associated with young women can create a feeling of shame and cause them to avoid asking for help. In a small study of 470 Austrian men aged 40 to 57, 32 men with symptoms of eating disorders had “significantly greater pathological manifestations on scales assessing eating behavior, dependence on physical activity. and satisfaction with body shape and weight  ”.
Ann Kerr believes that physicians have a role to play in diagnosing eating disorders and in the recovery of those affected. “It is clear that physicians can make a difference: they can provide information and raise awareness, in addition to providing appropriate care for patients with risk factors. Some may prefer to treat patients themselves using motivational interviewing or cognitive behavioral therapy, or to provide referral and follow-up. “
Eating disorders are not exclusive to young people; it is a mental illness that strikes regardless of age group, gender or race. If you or someone you know suffers from a disorder like anorexia, bulimia or binge eating disorder, know that we can help you.
Awareness Week eating disorders – From 1 st to February 7, 2017
On February 6, the Waterstone Clinic and the Waterstone Foundation will host a free, open-to-all information evening in Toronto as part of Eating Disorders Awareness Week 2017 (# SemTA2017). This evening, hosted by Dr. Blake Woodside, MSc, MD, FRCPC, will focus on new treatments for eating disorders.
For more information, click here or visit the Waterstone Clinic Events section . This event will be particularly relevant to families, teachers or anyone else with a particular interest in the treatment of eating disorders.
The Waterstone Clinic also offers a clinical webinar for healthcare professionals who want to learn more about the treatment of binge eating disorder. This activity will take place on February 7, from 1 p.m. to 2 p.m. ET, and will be
 “Thousands of middle-aged women suffering eating disorders in secret”, Times (London, United Kingdom) , January 17, 2017, p. 6. [ https://go.galegroup.com.ezproxy.lib.ryerson.ca/ps/i.do?p=AONE&sw=w&u=rpu_main&v=2.1&it=r&id=GALE%7CA477779213&sid=summon&asid=451bf93c974cccd5eed943f9f ].
 Mangweth-Matzek, B., K. K. Kummer and H. G. Pope. (2016). “Eating disorder symptoms in middle-aged and older men”, International Journal of Eating Disorders, vol. 49, no.10 , p. 953-957. doi: 10.1002 / eat.22550.
Journée Bell Cause pour la cause – Maladie mentale et dépendance : une combinaison plus fréquente qu’on pourrait le croire!
Au Canada, aidons-nous mieux les personnes atteintes de maladie mentale et de dépendance qu’il y a 10 ans? En fait, les problèmes de consommation et les comportements compulsifs sont en hausse au pays : il suffit de jeter un œil aux médias pour constater l’épidémie. Nous sommes en pleine crise des opioïdes : le fentanyl, le W-18 et le carfentanil se propagent dans les villes canadiennes à une vitesse alarmante. Des centaines de Canadiens ont fait une surdose de ces drogues, particulièrement en Colombie-Britannique.
L’augmentation de la consommation de ces drogues est-elle le vrai problème, ou simplement un symptôme d’un problème plus grand? Le gouvernement du Canada commence à se rendre compte que les surdoses ne sont qu’un aspect d’une question beaucoup plus vaste : la dépendance.
La Journée Bell Cause pour la cause met surtout l’accent sur la santé mentale et touche peu à la dépendance. Peut-être devrions-nous tous en parler davantage, étant donné que les personnes atteintes d’une maladie mentale sont deux fois plus susceptibles d’avoir un problème de consommation.
La dépendance est un sujet que nous continuons d’éviter parce qu’il est mal compris et est associé à une montagne de préjugés. Nombreux sont ceux qui croient que la dépendance est un choix et qu’elle ne se développe que chez une frange de la population. Au Réseau de santé Edgewood, nous savons que ces croyances sont fausses.
La dépendance n’est pas un loisir qu’on choisit de pratiquer un bon matin. Dans beaucoup de cas, elle commence par la consommation d’antidouleurs prescrits par un médecin pour atténuer la douleur liée à un problème de santé ou par une lutte silencieuse contre la maladie mentale. Dans d’autres cas, elle naît de l’envie de repousser des sentiments désagréables associés à des souvenirs ou à des traumatismes; la dépendance sert alors à engourdir la douleur physique et émotionnelle vécue. Malheureusement, tous ne survivent pas à cette maladie chronique.
Le bon côté dans tout cela? Les personnes en processus de rétablissement ont décidé que c’en était assez! Même si leur cerveau leur disait de continuer à consommer, leur cœur a compris que le rétablissement était la seule façon d’éviter l’autodestruction totale. Le rétablissement est notre solution pour aider les personnes aux prises avec une dépendance et une maladie mentale, et le moyen par lequel des familles en plein déchirement sont capables de se réunifier. Il donne des outils pour recommencer à vivre et aider les gens dans le besoin.
Lors de la Journée Bell Cause pour la cause, parlons aussi de dépendance et de rétablissement. Parce que peu importe l’âge, on peut s’en sortir.
Si vous souffrez à la fois de dépendance et de maladie mentale, nous espérons que les témoignages de ces anciens patients en processus de rétablissement vous encourageront à parler de votre situation dès aujourd’hui et à demander de l’aide.
Le rétablissement est le plus beau cadeau que vous pouvez vous faire.
« J’ai été en rétablissement pendant la majorité de ma trentaine, et le résultat a été carrément miraculeux! Si vous m’aviez dit à 33 ans (quand j’ai arrêté de boire) qui je serais et de quoi ma vie aurait l’air à 39 ans, je ne vous aurais pas cru. J’aurais probablement cru que vous aviez perdu la tête. Mais aujourd’hui, le mot « gratitude » ne suffit pas à exprimer l’émerveillement et l’allégresse que je ressens depuis mon rétablissement. Je suis tellement heureuse d’avoir la chance de vivre ainsi pour le reste de mes jours. »
« Pour moi, être en rétablissement pendant la trentaine, c’est comme vivre une nouvelle vie chaque jour. Me lever libre chaque matin est beaucoup plus agréable que d’essayer de me sortir de l’enfer dans lequel je vivais. Le cheminement est difficile au début, mais avec le temps, tout va de mieux en mieux! »
« Pour moi, le processus de rétablissement a commencé quand j’ai enfin pu non seulement accepter de l’aide, mais aussi la demander moi-même. Depuis ce jour, tout a changé. Les choses n’ont pas toujours tourné en ma faveur, mais il y a toujours une solution et une leçon à tirer. Bien franchement, le souvenir de mon entrée en traitement est très flou. Mais s’il y a une chose que j’ai retenue et que j’applique encore pour m’aider à me rétablir, c’est ceci : il y a des gens qui ont déjà vécu et surmonté tous mes problèmes; je dois simplement faire de mon mieux pour créer des liens avec eux. Quand j’ai entendu quelqu’un dire que la dépendance était comme un suicide à long terme, j’ai réalisé que je devais affronter la réalité et admettre, malgré tout ce que j’avais pu me dire, que j’étais en train de devenir exactement comme mon père. Grâce au processus de traitement, j’ai pu reprendre le contrôle sur ma vie. »
« Choisir la sobriété, c’est choisir une nouvelle vie. Pour moi, rétablissement égale LIBERTÉ. Vous trouvez cela bizarre? Ce ne l’est pas. Maintenant, je ne pense plus avec obsession à mon prochain verre ou à ma prochaine dose, pas même quand les choses tournent mal. Si ce n’est pas cela, la liberté, qu’est-ce que c’est? »
 CAMH. Mental Illness and Addictions: Facts and Statistics. [https://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx] (Consulté le 24 janvier 2017).
Bell Let’s Talk Day – Mental Illness Coupled with Addiction Are More Common Than You Think!
Are Canadians doing a better job at helping people with mental illness and addiction than they did 10 years ago? The truth is that the number of people developing problems with substance abuse or compulsive behaviours is increasing. You can go on any news outlet right now and see that there’s an epidemic taking place in our country. There’s an opioid crisis with Fentanyl, W-18 and Carfentanil hitting Canadian cities at an alarming rate. Hundreds of Canadians are overdosing on these drugs, especially in BC.
Is the increase in these drugs the real problem? Or is this just part of larger problem? The Canadian government is beginning to realize that these overdoses are part of a much bigger problem- addiction.
On Bell Let’s Talk Day, most of the focus is usually placed on mental illness but there isn’t a lot of conversation about addiction. Perhaps we all need to talk about it more, given the fact that people with a mental illness are twice as likely to have substance abuse problems.
Addiction continues to be a subject that we avoid because it’s misunderstood and carries a ton of stigma. Many individuals believe addiction is a choice and it only happens to a certain group of people. At the Edgewood Health Network we know that this not the case.
Addiction isn’t a hobby that someone decides to pick up one day. Many people who have developed an addiction may have started using pain medication because they were prescribed by a doctor to help them with a medical condition or they were struggling in silent with mental illness. In other cases, it was a way of avoiding unpleasant feelings as a result of past memories or trauma. Addiction was a way to numb the physical or emotional pain that they lived through. Unfortunately, not everyone survives this chronic disease.
What’s the upside of this story? The people who are in recovery decided that enough was enough! Even though their brain told them to keep using, their hearts understood that recovery was the only way that would prevent them from total self-destruction. Recovery is our answer to helping people who are living with addiction and mental illness. Recovery is the reason why families who were falling apart became whole again. It gives people the tools to live again and give back to others who are in need.
On Bell Let’s Talk Day, let’s talk about addiction and recovery because it doesn’t matter what age you are, whether you are 30 or 50. People do recover.
If you are struggling with addiction and mental illness, we hope these quotes from our alumni in recovery will inspire you to talk to someone today and ask for help.
Recovery is the greatest gift you can give to yourself.
“I have been in recovery for most of my 30’s and it’s been miraculous! Had you told me at 33 (when I got sober) who I would be and what my life would look like at 39, I would have told you it wasn’t possible. Maybe even that you were crazy. Gratitude is too simple a word to describe the awe and joy I have in my life now that I am living recovery. And I’m so excited I get the chance to live the rest of my life this way.”
“Being in recovery in my 30’s is like living a new life daily. Waking up every morning in freedom is much better than trying to get out of the hell I was living in. Recovery at first is challenging but as time goes on it gets better and better!”
“Recovery began for me when I was finally able, not only to accept help, but to ask for it. Since then everything has changed. Things haven’t always gone my way but there has always been a way out and a lesson to learn. Honestly, coming into treatment was such a blur for me. But if there was one thing I took away from it,that I still use to support my recovery, it was this: A community of people exists who have experienced, and overcome, every single problem I have in my life. What is required is my effort to connect to them as best I can. When I heard the words that ‘addiction is suicide on an installment plan’ I realized that I had to face the fact that, despite all I had ever told myself, I was becoming just like my father. Treatment is a process that allowed me to reclaim my life as my own, not anyone else’s.”
“Sobriety is a choice for a new life. Recovery to me is being FREE. It sounds weird but it’s not. I’m not thinking or obsessing of when my next drink is going to be and when I’m going to get high on drugs. Now it’s not even on my mind when things go wrong. If that’s not freedom what is?”
 Mental Illness and Addictions: Facts and Statistics-CAMH. Retrieved on January 24, 2017 https://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/addictionmentalhealthstatistics.aspx