White Knuckles & Wishful Thinking: How to Learn from the Moment of Relapse - Softcover

Über die Autorin bzw. den Autor

George Manter DuWors, Manter DuWors, MSW, BCD has worked in virtually every phase of chemical dependency and mental health treatment, including in- and outpatient treatment, employee assistance, drinking drivers, and private practice. A 1965 graduate of Walter Murray Collegiate Institute in Saskatoon, he received his BA in 1969 and his Masters of Social Work in 1977, both from the University of Washington,Seattle. An enthusiastic trainer and speaker, George DuWors maintains a full-time addictions practice in Everett, WA. He has presented "Learning From Relapse" workshops across the United States and Canada, and in the United Kingdom. He may be reached at gduwors@gte.net or a website to be developed.

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(CHAPTER 9) Dr. Jekyll, Meet Mr. Hyde - An Exercise1 The first question of the author's favorite group exercise is always the same: "How many of you have been told you are a 'Jekyll-and-Hyde' when you drink?" The answer today is typical. Twelve of the sixteen alcoholic inpatients raise their hands. "How many have at least been told you are a different person when you drink?" All the hands go up. "Okay, what I'm going to do is divide the blackboard in half. I want each person here to share one example of what you are like sober. And how it changes when you drink." Several hands go up immediately: "I'm polite when I'm sober and belligerent when I drink. Nobody can tell me anything." "I never miss a day of work sober." "I'm shy sober - when I drink, I'll ask anyone to dance." The examples flow freely and the counselor's job is to keep them as specific as possible. One man offers, "I lie a lot when I'm drinking." "Could anyone in the group give me some examples of the lies you tell?" Again, they come through with their personal cover-ups and excuses. But one of them looks a little puzzled and embarrassed. "When I'm drunk," he shares, "I'm likely to tell any damn story. Hero in the war. Test pilot. Private eye." "Anyone else like that?" There are a few sheepish grins around the room and some nods. It seems helpful to clarify that alcoholism generates two kinds of deception. The "survival lie" to get booze or to escape consequences of drinking it. And the seemingly harmless "fantasy lie" to seem to appear larger than one really is. Both sides of the board are full now, so it is time to start looking at the meaning of the facts we have laid out. "If most drinkers experience similar kinds of personality change when they drink, what does this tell you about the problem? How does it help?" A slim, young black man voices a reasonable and frequent conclusion. "The Mr. Hyde side of the board gives you a lot of reasons to not drink." "Dis-incentives -- good reasons not to?" There are usually murmurs of agreement. "That makes sense -- but see if this does. How many years have each of you known about your personality change. How many years ago did you first hear about it?" We add up there answers, one by one. The total for the group of sixteen is over one hundred fifty years. It's time to take off the kid gloves. "It would be reasonable to think Mr. Hyde's self-destructive behavior is a strong reason not to drink. Yet the group has continued to drink for almost ten years, on an average, being aware of it. How do we make sense out of this?" The room is very still. It is as if each alcoholic/addict there stopped breathing or moving at the same instant. However, a tougher question remains. "Try thinking of it this way. The goal of all chemical dependency treatment is to help you not do one thing. Take that first drink or drug. Have you ever asked yourself, who takes that drink, the "dry" Dr. Jekyll or the "wet" Mr. Hyde?" Several of them mutter, "Dr. Jekyll" shifting in their seats. The air has left the room again and people need to catch their breath, to let it sink in. At this point, it is important to have a question we can work with. "Dr. Jekyll, without a drop of alcohol in his brain, picks up the first drink and changes himself back into the monstrous Mr. Hyde. There must be something about being Mr. Hyde that he prefers -- what is it?" The group comes back to life. Doctor Jekyll "gets bored", "can't relax", "gets fed up with being a people-pleaser." Mr. Hyde "has all the fun," "gets the sex," "never worries." Now, we can circle back to the most important question of all. "How might your answers help?" One of the more verbal members of the group articulates it perfectly: "It tells you what Dr. Jekyll has to work on, sober." At this point the war hero/test pilot/private eye puts up his hand. "Think it's gonna be kinda dull around here if I just gotta be me all the time," he comments. "You fear you will miss the fantasies?" He nods. "Let me put it another way. You are not just saying good-bye to a liquid chemical, ethyl alcohol. What Dr. Jekyll loves most about living in Mr. Hyde's fantasy world is the "powerful illusion of power" [1], power to recreate your self and universe at will. This is, of course, the power of God. Anybody here remember Step One of the AA Twelve Steps?" One of them sees the connection. "Admitted we were powerless!" Sometimes the beginning is just the right place to end. This exercise works at the beginning of treatment with virtually any group of alcoholics. But with primary alcoholics, the results are consistent and the identification is built-in. A caution: Cocaine addicts who do not identify as alcoholics may complicate it, either because they feel powerful all the time, or because their paranoid personality changes go so far beyond the loss of reality experienced by an alcoholic Mr. Hyde. Heroin addicts may identify with the radical change in behavior when using, not so much with the personality shift. The author has only tried the exercise once in an inpatient dual-diagnosis program. Never again! The most consistent group reaction is dismay at the realization that "the good guy" takes the first drink, that moment of silence. The goal of the exercise is to help newly sober alcoholics see and feel - to "realize" - what so many have never really grasped, to think about what it means when the sober person takes the first drink/drug of relapse.

The separation of the "good guy" from the act of taking the first drink turns out to be crucial. Without understanding how this works, you will never fully understand what makes continued drinking possible. The distancing of the "good self" from the actions of the "bad self" robs the real self of an internal reason to change. Exploring the emotional reactions to this truth can be productive and healing, even though shame and guilt often surface first. But if they are faced, it becomes possible to face how the disease controls the sober mind, and to do the work that will prevent the diseased control from coming back. This is true "relapse prevention." The mental separation between self and action we see here creates an illusion for the person. It may actually feel like a "demon" somehow took over, that something other then the self is in control. But this experience is a direct result of the mental separation. In exploring further, we may call it: