Packed house. My name is Alan Hyde. I'm a licensed marriage and family therapist based out of Southern California. And I'm also a grateful member of the program of Al-Anon, which is a 12-step program for friends and family members of alcoholics. We're going to talk a little bit about that. We're going to talk a little bit about the alcoholic in our clinical settings, but mostly we're going to talk about how the 12 steps kind of help us as clinicians and help the friends and family members of alcoholics. Earlier this morning, I showed up for a talk and no one was, the speaker didn't show up for the talk. And there was a gentleman in the room and he said, well, you know, when you're scheduled to speak on a Wednesday, you know, at the end of a conference, that's, it's going to be bad. And I'm sitting there thinking, gosh, you know, so I go outside and I called my sponsor after that. Cause I, you know, I was getting a little anxious. I was like, what if no one shows up to my talk? Right? They didn't show up to their talk, but what if no one shows up to mine and my, my sponsor, he has a really good way of calming me down and getting me to see the full picture. And he said, well, whoever does show up, you know, those are the ones who take it seriously to show up the last slot on the last day. So I appreciate you guys being here and we'll see if we can get you some good information to take back for your clients. I'm a bit of a storyteller, so I'm going to let you guys get to know me a little bit as we get into this. And I'm going to tell you some stories about some clients and a little bit about the program and some skills that I've learned as I've walked with my clients and their 12 step journeys as well as my own. When I was 29 years old, roughly about four and a half years ago, I was working as a licensed therapist at a dual diagnosis treatment center. You know, my career was growing. I had a lot of goals for myself. Things were going pretty well, but when I would go home at the end of the night to my apartment, I would feel a haunting loneliness. You know, I couldn't shake it. I would walk around, I'm going off script here, I would walk around the block where I live down in Southern California and I would just feel empty. You know, I felt like I would go to work and I was making a difference in people's lives, but I couldn't really figure out why I would go home and I would feel so lonely. And then a trusted colleague approached me at work and she said, young man, you're too good at this not to figure out what's going on. And she sent me to a colleague of hers who had been doing therapy for about 33 years and the first session I walked in, I was a puddle on the floor. She pinpointed instantly that I had grown up in an untreated alcoholic home. And she was quite direct with me and told me, you need to go to Al-Anon tonight. And I didn't go. At first I dodged, I ducked, I made excuses and when I came back in the next week, she looked me in the eyes and she said, I'm unwilling to take your money if you're unwilling to do the work to get better. I went to a meeting that night and I've been going ever since. As we get into this, we're going to talk about the countless clients since then that I've worked with that I've watched the same process unfold for them and why it's so important for us as clinicians to be referring to these programs. Today we're going to go over a brief introduction to the family, the Al-Anon family support groups and 12 steps in general. We'll give you kind of a brief overview. We're going to talk a little bit about who's affected by the disease of alcoholism, help and hope and then we're going to go into why it's important for us as mental health professionals to refer to Al-Anon. We already can generally say like, you know, it's a good idea when the addict comes in to refer him to AA but what about the friends and family members? We're going to talk a little bit about that as well. And then we're going to take a transition into how to spot it in our clinical practice and then we will make a final transition into talking about this step 10 of Alcoholics Anonymous. The 12 steps are the same in both programs, AA and Al-Anon, which I'll refer to as we go. And in step 10, we're going to round it out at the end with the THINK acronym, right, that we learn in our 12 steps and I've watched clients utilize and get a lot of benefit. So we'll give you some tools to take back, you know, that you guys can utilize with your clients as well if it ever comes up. Welcome. Al-Anon family groups, I guess the best way I can explain it is they're a 12-step program, right. We use the same 12 steps adopted almost word for word from Alcoholics Anonymous and it's a program for friends and family members who have a relationship, any type of relationship with an alcoholic, identified or not. It's a program of attraction, not promotion and I really like that aspect as a clinician. I don't need to sell anybody on Al-Anon, I just need to present them with the information and similarly enough as I was sharing in my own experience, we know we got to go and take care of these things. And clients are pretty good, right, when they're presented with the accurate information of help and hope, they typically receive it. And so having that information for clients available, sometimes it's just a matter of sharing that this is a program that's available to them, they find it very, very helpful. I always explain to my clients is imagine you're late for work and your car is broken down. You have two options. You can run to work or you can take the bus that's across the street. If you run to work, you have complete control of the situation but you're probably going to be out of energy by the time you get to work and you're probably going to be late anyway. But if you take the bus, it runs on a schedule, it shows up every single day, you're probably going to get to work on time and when you get there, you'll have energy to do your job or at least enjoy your morning coffee, all right? And so I find that usually clicks for clients of like, you know, they're feeling pretty lonely and they don't know why and they can't really trust. They're starting to understand, can't really trust my behaviors. How about I go somewhere where people are consistently showing up and at least they have routines and structure and some type of program? And so I often point them and I share this, I keep this in my clinical office and I share it with my clients is the Al-Anon Declaration. When anyone anywhere reaches out for help, let the hand of Al-Anon or Al-Ateen always be there and let it begin with me. My therapist always shares with me, I don't, she says, I don't want to overstep my bounds because she's a 12-stepper as well, right? And I have a sponsor and I see her once a week and, you know, but she always reminds me, you know, my job is to ask you about your recovery and to let today begin with me, right? To really remind each other how important it is for us to take care of ourselves and I've always valued that, that my clinician knew about these things, right? And I was a therapist for seven years before I got this information, right? And so I like to come to, you know, conferences like this and share the information because not everybody knows about it, right? And certainly not all of our clients so that this could be valuable information to take back to them. Who's affected? So alcoholism is considered the family disease and it affects those who have a relationship with a problem drinker. Like we mentioned before, whether that person has identified as an alcoholic or not, we're still impacted by the behaviors. Data from 15,935 responses in the 2021 Al-Anon membership survey suggests that 67 out of 100 members report being affected by alcoholism spanning two or more generations. Two or more generations, right? So people are not getting the information, right? And not breaking cycles. This is what, you know, when I first walked into the 12-step rooms, this was the first big piece of information. I heard someone share, a good friend of mine now, she shared, we are cycle breakers, right? It doesn't mean that there won't be, you know, the Al-Anonic behaviors, which we'll talk about as we get deeper into this, or that, you know, there won't be an alcoholic, you know, relative or child as we develop in our lives. But the behaviors that we were introduced to, we have a chance to break them for ourselves and live a healthier life. And when behaviors have been existent in a family system for generations, right? It takes two or three generations to wash them out, right? To change them, you know? So this program, Al-Anon, helps those affected multiple generations to break that cycle. And what we're finding in the research is that majority, right, 67 out of every 100 individuals in Al-Anon are affected by alcoholism spanning two generations. As I was reflecting on this information and, you know, I was kind of cutting some things out and this week as I was prepping for the speech and this one I decided, that piece of information I decided to keep in because yesterday, just yesterday, I was just walking around the city enjoying the city before, you know, coming and doing this and I was walking down the street and I got approached by a salesperson, an environmental advocate, if you will. And for those who know sales, right, the main objective is to manipulate you out of your money, right? To separate you from the money in your wallet, right? And they do it with one really effective tactic which is a compliment sandwich, right? They give you a compliment, they give you the sales pitch, and then they give you another compliment, right? So as I approach this young lady, she stops me and I'm a friendly guy, right? She says, you look friendly and I guess I just kind of have one of those faces, right? So I stopped and I started talking to her and, you know, she's looking, she was looking for information to compliment, right? So she's like, what are you doing here, you know, in the city? And I shared up speaking at the APA conference. She's like, what's the APA? And so I shared what it is and she said, are you a therapist? I said, I am, right? And without having to prompt her at all, she launches, she launches into a story about how her father a couple years had passed away to alcoholism, right? It had a severe issue with alcoholism and that her brother was coping with that loss by drinking too much as well, right? And she was sharing with me, I'm not sure if he's an alcoholic, but it seems to be that's how he's dealing with it. And it dawned on me, right, the individuals who are affected are all around us, right? Probably some of us in this room have people in our lives who are alcoholics, I know it's true for me, right, as I stand up here speaking about these things, right? There's so many articles that you can find these days on the alcoholic, the statistics, right, which we're going to get into in the numbers of just the sheer amount in the United States of America of alcoholics, right? But there's not a whole lot of information and statistics out there for the friends and family members who are affected and often exhibit the same types of behaviors just without the substance use, right? And I'm sitting there listening to her story and I realized she's no longer trying to sell me anything. And I thought for a moment, I just kind of took a deep breath and I thought for a moment, I learned a long time ago in my recovery to stop thinking about things in the context of coincidence and start looking for my higher powers hand in this situation. And as she was telling me, I realized she's not trying to sell me on an environmentalist membership anymore. She's telling me about real pain in her life. And she looks at me and she says, being a therapist has got to be a really hard job, right? Being a clinician, it's got to be a hard job. How can, how do you not take things home with you? And I said, well, number one, I've been doing this a long time. And so my boundaries are that when I leave my office, right, I'm not here to help fix and save anybody. When I go home, right, I was only there to support that client that day and I'll see them next week as long as they can contract for say, I didn't go into all this, right? But in my mind, I'm thinking all this. And then I shared with her, but the reality is, is I also have a recovery program of my own that helps friends and family members of alcoholics. And I know that I can't cure the alcoholism. I didn't cause it, right? And I can't control it. And I told her a little bit about the program and she said, wow, I've never heard of this program. I think I'll check it out. But in that moment, see, Al-Anon wasn't a program of promotion, right? I wasn't trying to now flip the script and sell her on something, which was also effective too because she stopped trying to sell me something. I think she was trying to get out of there as quick as possible because she realized that the script had flipped. But I realized much like the information was shared with me, I had an opportunity there. Whether she ever finds herself in the room or not isn't my concern, but I had an opportunity much like we all do when we meet with our clients to share the information of things at work, things at work. And I could have walked away from that situation without sharing any of that with her. But I just find it important. Just as much as coming and doing this today, I don't think it was a coincidence that that came up the day before. The day before I was going to talk about some generational alcoholism and how we can address it. If any woman on the street of San Francisco tells me about generational alcoholism in her family, coincidence, I think not. But there is hope. Although there is a lot of statistics on generational trauma, what I will say about the program of Al-Anon, this is a statistic that we do have from the 2021 membership survey, is that 83% of Al-Anon members are reporting improvement in their mental health within the first year of attending meetings. So if you didn't know about the program, now you're starting to, and it is helping people improve their mental health as it pertains to growing up or entering into an alcoholic dynamic. So the National Survey of Drug Use and Health is released once a year by SAMHSA. I never know if I'm saying that correct, right, because it's that weird spelling, right? But SAMHSA, they release it once a year. And here are some statistics that we need to know about the other side of the aisle, the alcoholics in our lives. 61.2 million people, or 21.9% of the population, used illicit drugs in the past year. 9.2 million people, 12 or older, misused opioids in the past year. And 46.3 million people, 12 or older, or 16.5% of the population, met applicable DSM-5 criteria for substance use disorder. 16.5% of the population. Here's the kicker about the young lady that I met yesterday. She's from England, and she'd only been here for three months, all right? These are the numbers in the surveys that we have for just the United States, but this is true all over the world, and it's important for us to be continuing to talk about it, to know about it, and to find valid solutions, all right? Because if we think about 16.5% of the population, every single one of those individuals has a mom, has a dad, has siblings or friends, right? However many of them, right? This is why we can't pinpoint exact percentages in those directions, because it's just so vast. A lot of people are affected by the disease of alcoholism, not just the alcoholic. And as clinicians, we're subjected to it quite often, all right? This isn't me saying you need to go to a program, right? This is just sharing. This is the information that can also further shore up your boundaries with interventions at work and places that you can send your clients who may be struggling with the alcoholic in their life. This next stat, I think really, I think it's the growing problem in our country here in the U.S. is with that 16.5% of the population that's meeting criteria for substance use disorder, 94% of them in the last year received zero treatment, none, none whatsoever. What that tells me, right, without the numbers and without stretching too much, right, what that tells me is there's a lot of individuals around those people as well that are trying to help, right, mostly trying to, like, save, right? How many times have you seen a family member or heard maybe in your clinical settings the family member of the alcoholic also placating and saying, it's not that bad, right? What can we do to help, right? The right question is what can I do to help myself so that I can get out of the way of the alcoholic and stop averting their consequences so they'll go get treatment and we can all live a happier, healthier life, right? But if 94% of the people with DSM-5 criteria for substance use disorder aren't getting treated, then what about the others who aren't abusing the substances who may not even know that they're struggling emotionally? What about them? It's why I believe it's important for us to start to change the conversation, for us not just to focus on the alcoholic, but to focus on the support that we can provide for the family members, right, and a lot of times for the clinicians who are working with these families and these individuals. Recently I was in a meeting, a 12-step meeting, and the topic was hope, and I thought it was really poignant and relevant, especially prepping and preparing for this presentation and to talk with you guys. She shared when she thinks of hope, right, she tells herself this acronym in her mind and she carries it with her. She actually has it on a little card that she carries in her purse. She says, I hear others share their courage, strength, and hope, which can benefit me on my road to recovery. I open my heart and my mind to different ideas and become willing to consider that what has helped others may help me too. I practice what I learn using the steps, serenity prayer, slogans, and other program tools to gain peace of mind, and I educate myself about the disease of alcoholism so I can better understand what my loved one is going through, and I use Al-Anon conference-approved literature to work toward recovery. I don't know about you guys, but when I first started going to program, stuff like this would get shared, and I would just think to myself, like, how powerful, right? Somebody who has never studied, right, clinical interventions or worked in any clinical settings is sharing an intervention that we can utilize with our clients in a clinical setting that will have huge impact. Since I heard this in my meetings like six months ago, I've used this like every week with at least one client, and they're always like, wow, this is, I'm going to write this down and carry it with me, as I do as well, right? It's powerful stuff. I think to myself often, what a powerful program, what a powerful program, and thank God that it's available. Not only does the alcoholic need help in addressing their challenges, struggles, and illness, but the family also deserves the same opportunity. When the family and the alcoholic receive help through learning, love, and support, it enables everyone to move toward the solution, rather than continue to live in a circular nature of the problem. A couple years back, after I had gotten myself into program, I had a young man come into my office, and he'd grown up in a pretty significantly abusive alcoholic home. A loud environment, dad would yell often, was often physically violent, and mom was quiet, right? Didn't stand up for him, didn't know how, right? We were able to identify in our work, right, mom's limitations and dad's limitations to see that they're only human, but at the same time, he was very angry, right? He was very upset, mostly at the world and other people, and didn't have a whole lot of solutions being offered to him. He had seen four other therapists prior to seeing me, and none of them, he came in and he said, none of them really, I feel like, understood what was going on. As I do when a client comes in to me for the first time, I ask them, what did you like about the last provider, what did you not like? Mostly I can assess where their personality structure is, and how quickly they can bounce back if I step on a landmine, right? And also just to make sure I'm not stepping on landmines, right? And as we were exploring his dynamics, I said to him at the end of the session, I said, here's what I want you to do, I want you to go to this program and I want you to give it a shot. They say to go to at least six of them before you decide it's not for you, I want you to check out Al-Anon and I want you to come back and I want you to tell me about it next week. He went to the program later that week, he came back in our session, and he reported that he went to program. A couple years later, he continued going, a couple years later he came into session and he said, Alan, I'd like to talk about my suicidal ideation. So I went into my assessment, are you feeling suicidal today? All the check marks, and he said, no, no, no, I'm not suicidal today. I said, okay, so what suicidal ideation? He said, well, when I first came to you, I was having consistent thoughts of taking my life, thoughts of death and dying, feeling hopeless, wanting to end my life. He said, when I went to my first meeting, there was a man standing at the door. We call him the greeter. And in Al-Anon, there's a really simple service position. We call it the greeter. It's a dude who stands at the door and welcomes you, whether you've been there for 50 years or you're coming for the first time. He said, this man asked me when I got there, he said, are you a newcomer? He said, yeah. He said, OK, well, why don't you come in? You can share if you want during the meeting, but you don't have to. But we just want you to listen. Feel free to ask us any questions before and after the meeting and welcome. He said, Alan, before going to that meeting, I often thought about taking my own life because I just felt like no one in my life was going to change. Everyone was going to keep using substances. I couldn't help fix or save them, and I didn't know what to do. And he shared with me. He said, that first meeting, I realized something. That was the first time in my life that another grown man looked me in the eyes and said, welcome. And I never had a suicidal thought again since that point. And I thought to myself again, what a powerful program. What a powerful program. I'm thankful, as a clinician, to know that these things even exist, that there will be some random dude standing at the door, or a woman, depending. It's like you got all men meeting, all women meeting, co-ed meetings. There's going to be someone standing in that door to welcome people who feel unwanted, unloved, and alone. And this guy was. The kicker for me in that scenario is that I've often, in my going on 11-year career, prided myself on really effective assessment. But when I asked him about his suicidal ideation after he shared this story, he said, well, I wasn't lying to you. I just wasn't being honest. And I think to myself, oftentimes, as clinicians, we ask all the right questions. But what if they're just not ready to tell us? What if they need another form of outside support to get them ready to tell us? And what I learned is sometimes getting ready to tell somebody can take you three years. But we're in the business of creating relationships, so we might as well create long-lasting, healthy ones. This program will help you do that. It will help you, as a clinician, walk with another individual in their life to the point where they feel understood, because you are the clinician who referred and recommended that they go somewhere that actually worked for them. And I'm not going to stand up here and tell you this works for everybody. But for this young man, it was the first time in his life that another individual who was trying to be healthy in their life looked him in the eyes and said one simple word, welcome. And that saved this young man's life. And when I sit with him in our clinical meetings week to week, I'm convinced of that. Since I've heard that share from him, I just felt it in my gut. I could see it on his face. I was seeing a different young man in front of me. There is hope. Here's where we come in. In 2021, Al-Anon membership survey showed that 41% of the 10,848 members surveyed reported that a mental health professional had referred them to Al-Anon. 41%. Personally, I'd like to see that number go up. But I think it's just important that mental health professionals are referring to this program in general. And it's my hope that maybe a few of you, after hearing some of the information today, will take this back. It is an international program. So even if you're not from the United States, Al-Anon meetings are on every corner. So hopefully, that 41% will go up to, I don't know, 41.5%. And I can be like, I know a few of those people I talked to. The survey showed that members with four or more years, this I thought was interesting, that members with four or more years of continuous membership while also seeing a mental health professional reported significant improvement in their mental health. Not a quantified percentage, just significant improvement. And that was compared to the members who were zero to three years, that kind of weren't really reporting much of their mental health improvements yet. So what that tells me is that, as clinical providers, if we can refer our clients to these programs and stick with them for a significant amount of time and they stick and program, that their mental health will improve over time. And as we mentioned before, I think that's the business we're in, is creating long-lasting, healthy relationships. Whether they stay in our offices for four or five years, or you're seeing them once a week, or you're just seeing them once a month, what's important is that we stick with them in the referrals that we're making and the support that we're providing. And if we do so with 12-steppers, they're getting better because of it. And if you really think about it, this is just an anecdotal piece, well, they grew up in homes where people weren't showing up for them. And so now they're surrounded by a support network of people who are showing up for them. Go figure, they're getting better. And it's improving their relationship health and their mental health. Colin? Yeah. I'm thinking of the client, or my patient, who is thinking about their loved one, a spouse, a sibling, or a child, who's got a substance use problem. And so they see it as, well, how is that going to help my son stop drinking? So why do I need to go? He needs to go. Yeah, and I have family members ask me all the time. My answer is simple, it won't. You're not the cause of why your loved one is drinking. It's not your job to get them to stop. This program helps us look at our part in it, what we can do to take care of ourselves. So as we kind of get a little bit further into this, we'll talk a little bit about detachment and why that's so difficult for our family members or the individuals that come into our clinical practice to let go of what the alcoholic is doing. Listening for the sound of opening beer cans, throwing away expensive liquor, all the behaviors. People want to help, but it's not their job. And so I think as clinicians, prepping to refer to these programs, it's important to remind them. We're not here to get the alcoholic to stop drinking. We're here to get out of their way, essentially. And that can be really hard. You're going to experience a lot of emotional turbulence in your sessions when we start to suggest detachment and getting out of the way of the alcoholic. But when we come into meetings, we'll get like newcomers. And they'll often share that. I'm only here to try to figure out how to get my loved one to stop drinking. And the only thing we say to them is keep coming back. It works. That's it. It's not my job to get someone else in program to let go of the alcoholic's behavior. My job is to model what the behavior is to let go. And they find it over time, if they keep coming back. And that's, I think, why the consistency of clinicians sticking with their clients for long periods of time as they explore recovery is why they're getting better. Because they're not going to have those answers at the beginning. And they're going to want all the answers right out of the jump. And we just can't provide all those right away. Nor would any of us recommend that. In one session, I'm going to give you all of the information. We just burn ourselves out. I hope that answers your question. Here's why it matters, too, for us as clinicians to have awareness of the treatment of the family disease. Is that in the survey, the Al-Anon membership survey, eight out of 10 members report that receiving treatment or counseling prior to attending Al-Anon meetings affected their life positively. And nine out of 10 of those members reported that receiving treatment after starting to attend Al-Anon, so now they're around people who are, that's affecting their life positively. So being a provider and knowing this information and walking with our clients in that journey is impacting these individuals positively. It's improving their mental health. And it's giving them a grasp on the conversation we were just talking about of how to let go of someone else's behavior, how to find compassion for the person who's still drinking or using in our lives, and how to start to recognize this. I think this one's an important piece, too, is how to start to recognize that it's a family disease. It's not just this one person. Oftentimes, it's a generational disease. Not always, but as we saw earlier, 67 out of every 100 members are reporting that it spans at least two generations. So I think a big piece of recovery on both sides of the aisle is acknowledging that we're up against generational trauma here. We're up against generational alcoholism or just substance use in general, and recovery is a way out of it. 12-step recovery teaches one skill better than any other approach I've ever seen, and that's detachment, like we were kind of just touching on here. I refer my clients to 12-step meetings for this one skill, knowing that in program, they will also find meaningful, lasting community, healthy coping strategies, and ample opportunities to connect and have fun with good people. Before I tell you a little bit about Abe's story, I'll interject here and share that essentially what individuals theoretically are engaging in a program like Al-Anon or Alcoholics Anonymous is, theoretically, it's social learning theory. Albert Bandura's 1970 social learning theory. I witness somebody doing something helpful, and they're receiving positive rewards from it. I might as well do that too. And so I refer my clients to these programs because I know over time they're going to be introduced to people living healthier lives who are being rewarded for it, and they're going to be introduced to a lot of them. And they're going to get to pick up on those behaviors and start saying to themselves, I'd like to be rewarded for healthier behavior too. How do I get what this person has? When Abe came to me, he was angry, much like I was sharing in my last vignette, if you will. He was self-righteous. A lot of our sessions were, he would tell me, I know best. And that was a comment he would make often, I know best. And in our early sessions, I could tell he was rough around the edges. He was 23 when he first came to me. And I would take a risk with him often. In the beginning, I would joke with him. And I said, it must be a bummer for somebody who believes that they know everything to be with a therapist who also believes he knows everything. And we would crack up and laugh together. And I would share with him, I understand, right? You believe that you have the answers. But why don't we explore why you believe you have the answers? What started to unfold as we explored why he believed he had all the answers was because he grew up in a chaotic, untreated alcoholic home. When we were going through his family tree, we saw that it spanned much further than two generations, at least three that we could see that he knew of. And it made him so sad when he saw it on paper, all right? He was tearful. He didn't know what to do about it. As we started to piece together the family generational alcoholism, he would continually bring up past behaviors of his mom, who abuses meth, his aunt, who abuses opioids, and dad, who kind of tries to control everybody, right? Dad, who was kind of the model of I know best, I know everything, right? And so as we were piecing all these things together, he would often tell me in his adult life that because everybody was so wrapped up in their struggles, he, as a child, he felt unwanted, unloved, and alone. And he didn't know what to do about it as an adult. And a lot of the work that I started to do with Abe was really about teaching him how to parent himself, right? And that's a lot of the work that I do with my clients in my private practice is we kind of get to know that little Abe inside of us, that little boy or that little girl, and how, as adults, we can start to talk to that inner child and really help that inner child feel supported and loved and really feeling trust from the adult version of ourselves. And I said, you know what, Abe? Here's what I want you to do. I want you to go to Al-Anon. And when you get there, I want you to listen to what people are sharing. And after you feel comfortable, I want you to find a sponsor. After you find a sponsor, I want you to start working the 12 steps with this sponsor. And throughout the whole process, I want you to keep me informed of how it's going. So he did that. And I'll share this as kind of like a side note, is any time I recommend directly for a client to go to meetings, I know it's a risk because they're going to be confronted with all of the work in these rooms that they've been struggling with for years. It's going to bring up old wounds, new wounds, new information. It's a lot in the beginning. And I took a risk and recommended that he go pretty urgently. And he did. And he's stuck with it. He still goes. I've been seeing him for three years. And he still goes every single week. And he came to me about a year ago. And he said, you know, I started going to meetings. About a month in, I found a sponsor. And I started working the steps. And as I was working the steps, we got to step 10, which we'll talk about in a little bit, which is taking daily inventory. And in step 10, I learned a really helpful acronym. I learned to think. Now, when I interact with my family members who I used to feel an overwhelming amount of resentment towards, I was angry and always telling them what to do. I always thought I had the answers as to what they could do to get better. Now, instead, I stop myself whenever I'm going to interact with them. And I think. And I found that I'm much more thoughtful in my interactions with the people in my life, whether I'm angry at them or not. I feel more honest with them. I feel like my responses and my behaviors are more intelligent and necessary. And I'm much more kind. And I thought to myself again, what a powerful program. What a powerful program, that these things exist to help individuals unravel behaviors and emotions in their family dynamics that before felt unmanageable. And now a young man with no clinical training, no emotional awareness when he first came to me, is now able to look me in the eyes and say, when I talk to my dad, I can be thoughtful, kind, and honest, tell him how I'm feeling without yelling, screaming, or telling him what to do. These are the things that individuals are learning in 12-step meetings. It's definitely true in Alcoholics Anonymous. We already know that. The program's been around forever. But it's also true in Al-Anon, which is a program we're talking a little bit about today. So how do I know if Al-Anon can help me? Heavy drinkers commonly say that their drinking is not a serious problem. Some people, it's not as serious a problem as some people think. People who are close to them also tend to minimize how seriously the drinker's alcohol abuse has affected them. They're trying to keep things as normal as possible under conditions that are sometimes unbearable. These questions can help decide if you could benefit from visiting an Al-Anon meeting. So I want to kind of go through this. This is on the Al-Anon's main website. It's kind of one click away from the home page, where like, how can I find help? And this assessment will pop up. And I think these are really powerful questions. They're super simple to ask. And odds are, when you ask them, you're not going to get through this whole list before someone says yes. Do you worry about how much someone else drinks? Well, if you grew up in the United States, your answer to that's probably yes. Do you have money problems because of someone else's drinking? Do you tell lies to cover up someone else's drinking? Do you feel that if the drinker cared about you, he or she would stop drinking to please you? That's a big one that pops up in clinical settings, that this person is drinking because they don't care about me. It's often a common reaction. Are plans frequently upset or canceled because of the problem drinker? Oh, we were going to go on this vacation, but I'm worried about if they're going to drink when we get there. Do you make threats, such as, if you don't stop drinking, I'll leave you? Are you afraid to upset someone for fear it will set off a drinking bout? Have you ever been hurt or embarrassed by a drinker's behavior? Do you search for hidden alcohol? Have you refused social invitations out of fear or anxiety? Do you feel like a failure because you can't control someone else's drinking? Do you think that if the drinker stopped drinking, your other problems would be solved? I've never gotten through this full assessment without a yes. Now, granted, most of the individuals being referred to me are being referred by clinicians who know what my specialty is. So there's the presupposition that they're going to qualify for these things. But I'll tell you, with the percentages we looked at earlier, if 16.5% of the population is dealing with substance use and they all have friends and family members, well, that's, I mean, it's got to be at least half the population that's going to answer yes to these questions. And they're out there. And they're not being treated. That's why we've got to change the conversation. We've got to start talking about both sides of the aisle and what we can do as clinicians to get people in the right places for support. And if you answered yes to one or more of these questions, clinician or just random person on the street, Al-Anon may be helpful. I'm a huge advocate. Here's some observable behaviors. I kept these pretty generic. We can discuss them if you have questions on them as well. Essentially, they're the don'ts of Al-Anon. We have in our program the do's and don'ts. These are the don'ts. And you can usually see these pretty clearly in clinical settings if someone's being self-righteous. One of the ways I always assess this, it's one of the clearest ways I see it in clinical settings, is when someone is overtly angry at somebody else or in that anger believes that they're the one with the right position, we can be pretty sure that there's going to be a lot underneath that behavior. There's going to be a lot of self-righteousness in that anger. There's going to be plenty to explore, which may point us back to maybe some alcoholism, substance use, or difficult traumatic family dynamics. When an individual is dominating, nagging, scolding, or complaining, in a clinical setting, for the longest time, the place where I would see this most consistently is in group therapy. They would want to dominate the conversations, tell other people, oh, I have the answer to that. And they wouldn't wait for clinical interventions. So if you run group therapy, you'll see that one a lot. They'll complain if you're one minute late. And we pay attention for those behaviors for these recommendations, at least in the treatment centers I worked in. They bring up the past consistently. I feel like this one is very generic. What this means is they bring up the past of the problem drinkers' behaviors consistently. They can never live in the present when it pertains to someone else's behavior. They constantly have to talk about, well, you did this, and remember when you did that. And they constantly bring up the drinker's behavior. If those things are happening, it's possible that there's an alcoholic or a problem drinker, and they would benefit from the program of Valanon. Making threats. And I don't mean physical threats. I mean, if you don't stop drinking, I'm going to kick you out of the house. Or I'm breaking up with you if you don't stop drinking. General threats around the substance use. Being a doormat. So this is a lack of boundaries. And you'll see this oscillate. It's the kind of one up, one down power. Differential of someone feels like they know what's best, but what they're really looking for is to find themselves in the victim position. So what they'll do is they'll say, well, I know what's best, and I can't believe you don't do this. Down here in the victim role, we'll get pissed, the drinker, and say, well, you don't know what you're talking about. And then this person's like, you always tell me it right, and it goes back and forth and back and forth. And oftentimes, the alanonic, if you will, the friend or family member, will feel walked all over. Because when you try to contend with someone who's using substances, at a certain point, they're inebriated, and they just don't care. You're going to feel walked all over at some point. And so a lot of those behaviors, when they start to come out, I help my clients see that they're engaged in that cycle. And the program would be helpful to get them off. Losing your temper. So that one's pretty straightforward. Especially in a clinical setting, if someone's losing their temper, you can pretty easily start to assess the underpinnings of what's going on there. Pushing others to change. So one of the hallmarks of Al-Anon is that we tend to be pretty controlling prior to getting treated. We want the individual in our life who we love, who's struggling with substance use, to get better. And we're usually willing to do whatever it takes to try to help them get better, but it usually gets us in a lot of trouble. Checking up on the alcoholic. So this was kind of what we were touching on before, of like listening for the sound of cans opening, pouring expensive liquor down drains, checking to see if they're coming home at the time they said they were going to come home. If you start to hear about those behaviors, then the program of Al-Anon would probably be a helpful recommendation. And being overprotective. This is a subtle one. When the alcoholic finds themselves in society experiencing consequences, oftentimes we'll see the family members trying to protect them. Like, well, what was the police officer doing? How dare them treat this person that way? Or when it's kids, it's like, well, what was the teacher doing? What was the principal saying? Why are they pinpointing and bullying and picking on my loved one? So they're being overprotective as opposed to approaching the situation from a reasonable place with boundaries and looking at the full perspective. If any of those behaviors are being observed in a clinical setting, then a conversation about Al-Anon may be helpful, if we start to identify that there is a problem drinker as a result of some of these behaviors. Now, this isn't a definitive list that says, if you're seeing these things and this person has a problem drinker in their life and they need program, it's saying, this is a doorway into an assessment, right? These are hallmark behaviors that you might see, right? But there's a lot of meaning and reasons behind these behaviors, but the doorway's there, right? To explain whether or not someone needs Al-Anon. Has anyone ever read Facing Codependence by Pia Milady? Just out of curiosity. Hey, we got one in the back. It's a powerful book. I'm not here to cram anyone's work down your throat, but this is a powerful book. It explains the dynamics of codependency. Some people are going in different directions with the research to maybe find a different word, but what I'm interested in in this research is it seems to explain the personality structure that gets developed in the alcoholic home. And you can see it pretty clearly as it develops in a clinical setting. Difficulty experiencing appropriate levels of self-esteem. Oftentimes, the individual who grew up in the alcoholic home, although a lot of times, as we've talked about, will feel, or they'll make comments that they're self-righteous and they believe that they know everything, but also underneath that exterior, that prickliness is usually a lot of self-esteem issues, low self-esteem. I'll give you an example, or at least a funny story. When I talked with my sponsor early on, he said, you know, a sponsor called me and he said, some days I feel like the most special person in the world and other days I feel like a worm. And his sponsor responded and said, maybe you're a really special worm. That's what recovery gives us. I'm just a person. I'm just a human. We all in this room, we have our education, we have our experience, we've been practicing in clinical settings, whatever it is that makes us who we are. Recovery's a great equalizer. We are just human beings. And that's, it's what recovery gives us, but it's also what the untreated individual is struggling with. There's no balance, usually, when you see it in a clinical setting, of appropriate levels. They don't look at themselves and see just a normal human being who's trying their best. They see someone who every time they try, they've done their worst. Because typically, they've grown up in a home where someone has told them that that's the case. Or behaviors in the home have told them if the words weren't direct. Some situation in the alcoholic home has made that person believe that they're less than. And they're typically, in a clinical setting, what you'll see first is they are striving to be better than. And you will see the oscillation. They will fall from grace. And they'll do it right in front of you. And if we know what we're looking for, we can refer them in the right directions. With those types of behaviors, go figure, there's difficulty setting functional boundaries. So I'm sure you guys have heard a lot of talks this week on some similar topics where boundaries was addressed. Some people put up walls and they guard themselves and won't let anybody in. Some people have no boundaries. And they'll let every violation in. All right, some of the topics I saw was earlier, even just today, like sexual trauma will perpetuate this. And it's also a form on the back end of the person doing the violation is also struggling with an addiction, not a substance addiction, but a sex addiction. All right, and there's a lot of different routes we can go with difficulty with setting functional boundaries but the important thing to remember is that the individual in your clinical setting who comes in who's either having a hard time saying no to people, right, or understanding where they end and the other person begins, right, or just having no desire for intimate relationships or connection with other people, if those things are coming up, then we've gotta assess deeper, right, to see did they grow up in a home or an environment where addiction was possibly a factor. And if so, well, there's a program for them, right? And I really do, I wanna stress, right, if the individual in your clinical setting had grown up in an environment affected by addiction, it's imperative that they get this program. It's not if these things are gonna become a problem, it's when. And I think as clinicians, we know that, that the nature of addiction on both sides of the aisle is progressive, it doesn't get better without treatment, it only gets worse, right? And that's true for the family members, even though they're not drinking. They just don't know it, usually until way later in life. You know, I was sitting with a group of dudes that I've known for the better part of five years now in my recovery program, and I shared with them, you know, I was like, I feel very blessed that I wasn't, you know, 50 years old, working in a job that I hated, and you know, that good people came into my life and told me about the good news of this program. And I was sitting next to this gentleman, and he like raised his hand, he's like, that's me, and we laughed, we had a good laugh about it. And thankfully, I'm in good company with these dudes, and they didn't take it personally, right? Because our recovery program's not personal. But it made me think, you know, there are so many people out there who are struggling, who need this support, who aren't getting the information. And it's not because the information doesn't exist, it's because the conversation's not being had. And so it's why I come to places like this, it's why I sign up to talk about these topics, and slide it in there wherever they'll let me, it's because it's important to support these individuals where we can. Which brings us to difficulty owning our own reality. So the individual affected by the disease of alcoholism, the family member may come in, and they may have a hard time identifying the honest truth of situations, right? How bad things are, how bad things have gotten. And there's quite a varying degree, we know in our clinical settings, that can range to, you know, all the way to severe mental health diagnosis, right? The separation from a healthy reality. Well, the family member of the alcoholic, although they may not have a severe mental health diagnosis, they may have a hard time owning, let's say, the problem drinkers drinking in front of them, and they tell themselves like, ah, it's not that big of a deal. Well, that's a difficulty owning reality, when you just told me that the person in your life who you love just got arrested for his third or fourth DUI, and you're telling me it's not that big of a problem. That's a difficulty owning reality, all right? So when we start to see those kind of things, well, now we know there's a program that can help them. Difficulty acknowledging and meeting our own needs and wants and being independent with others, or interdependent with others. All right, so that one's pretty transparent. We talk, and I'll refer my clients sometimes to the program of SLAA, which is Sex and Love Addiction Anonymous, and in that program, they talk about the three circles, the outer circle, middle circle, and inner circle. And without going into too much detail of what all that means, the outer circle is kind of like our basic needs, going to the doctor, brushing your teeth, getting up at a consistent time, going to bed at a consistent time. And when the individuals in that program start to address the core, the inner circle, which is the problems that they're engaged in, like whatever sexual compulsive or impulsive behaviors they're engaged in, once they start to separate from that, they find that the outer circle behaviors start to become much easier to take care of, right? Meeting their personal needs. And the same thing is true without the sexual compulsive behaviors a lot of times in the alanonics, right? The friends and family members of alcoholics. They start to learn how to meet their needs better because they're around other people who are addressing the true problem, right? And the family disease, which is me, right? If I could sum up, and just as a side note, right? What the program of alanon helps individuals learn is that it's not the alcoholic that's the problem. It's the disease that lives in the family system that has impacted me and caused my behaviors to go awry. And that's what really any 12-stepper learns is what can I do better? What can I do differently? And the final symptom here is difficulty experiencing or expressing reality moderately, right? So in the alcoholic, we have the clear example of that. They're out in society drunk and getting in trouble, right? And the family member of the alcoholic, it's not so clear because behind closed doors, no one's asking you, did you pour their liquor down the drains today, right? Did you go and turn over their room to find the substances under the bed, right? That's, right, difficulty expressing their reality moderately, certainly. The reality is is that person in your life is struggling with a disease and you're not helping, right? And as clinicians, our job is to try to say that as compassionately as possible, while also providing support over long periods of time so that you're not looking at your client and saying, you've got a problem, right? So that they eventually can move from not expressing their reality moderately to a more balanced place in their life, right? With proper support and a community of people who are also engaged in new healthy behaviors, right? So these are just some of the major symptoms that you might see in the codependent, right? In the alcoholic dynamic, the codependent being the friend or family member. Step 10, we're gonna make a quick transition here. We're done at 5.15, right? I wanna make sure we get you guys out of here at a good time as well. Step 10, continue to take personal inventory. And when we were wrong, promptly admitted it. I like this step a lot because whether you're a 12-stepper, right? Or gonna refer someone to 12 steps, this step will help people in their lives. I think this one step is, kind of sums up what therapy is in a nutshell, right? Continue to take personal inventory. That's what you do every week when you go to therapy. I mean, look at what I've done and how I can do things better. And when I did something wrong, I promptly admitted it. And if you can do that, or if our clients can do that, well, they usually find themselves living a pretty balanced life. Not perfect, right? But balanced, and that's the objective here. I included the prayer of St. Francis. This is a prayer that's recommended to 12-steppers to recite every single day. And if we go through it just kind of line by line, there's a lot of behaviors in here. Now, I'm not here ever, and I tell my clients this too, is like, I'm never here to promote any religion, right? What I am here to do is to promote healthy behaviors. And in this program that's been around for years and years is going to promote healthy behaviors. And one of them just so happens to be prayer, but you get to define what that means for yourself. But if you look at the words in line for line in the prayer of St. Francis, when you get into the middle of the prayer, where there is injury, pardon. Where I've been injured by someone else's drinking or someone else's behavior, I'm not forgetting, but I'm forgiving, right? I pardon them. I pardon them. I no longer beat them up for their behaviors. That's what individuals in program are finding, right? Where there's been doubt, I have faith, right? Where I was always questioning myself because the alcoholic told me I was nothing, now I don't doubt my own abilities. I have faith that I'm where I need to be. That's what individuals are finding in program. Where there's despair, now there's hope. And we've talked a lot about hope today. I've watched it in my clinical setting time and time again. I just shared two stories with you today, but I'm sure we all have countless. I know I certainly do, of clients who came in in absolute desperation, making desperate decisions. And through recovery, they found hope and a balanced life. And where there's darkness, they found light. I just kind of like that line. There's a lot of doom and gloom, I think that surrounds alcoholism and the family disease of alcoholism. And there's a lot of family members who get lost in it and in recovery, like it, shine not. Not the light that's supposed to fix or save it, but the light that it was never their job to fix and save alcoholism. They just needed to take better care of themselves and things would work themselves out. Now let us think. I'm gonna share with you just a few quick, important lessons from my sponsor. I talked a little bit about my sponsor in the beginning, and he also got a kick out of me talking to medical and mental health professionals about wise words that he shared with me. And while he's not a mental health professional, he's a lawyer, but he's changed my life a whole lot. My sponsor often reminds me when we're doing stuff like Step 10 to never miss a golden opportunity to shut up. He often puts the F word in there, but I wasn't sure of the room yet, so I left that one out. He says, remember that it helps to reason things out with someone else before you say something that you do not mean. Prior to recovery, I would fly off the cuff and say things I didn't mean all the time. Instead, in recovery, when I first met my sponsor, he said, here's what I want you to do. I want you to call me every single morning at 7 a.m. And he said, the reason I want you to do that is because the 10,000 pound phone won't be 10,000 pounds anymore, and you'll know that you can pick up the phone and call me any time there's a problem. In the beginning, I used to call that man off the hook. Can you believe what my brother said, or what my brother did? Can you believe my mom did this? Can you believe my dad did this? And this man at seven in the morning would just be like, good morning, how are you? He was just the most calm, consistent person. And I've witnessed that in my sponsees, and other individuals who are in the program with their sponsors, it's just a consistent behavior that you'll see for your clients when you refer them, is that now they have a sponsor in their life who they can contact every day. So if you're dealing with a lot of crisis in your clinical capacities, you may see a lot of that decrease when you recommend them to a 12-step program, because now they have someone who they're consistently engaged with, and a structure who they're talking to every single day. My sponsor reminds me of that consistently, pick up the phone. It says, when in doubt, call another member of the fellowship. If he's not available, call somebody else. And we have a phone list. In my home meetings, we have a phone list, and we give it to newcomers when they come in, and it has all the names and phone numbers of people who are willing to pick up the phone. We're not there to help fix and save you, but we're there to talk to you if you're having a hard time. And oftentimes, people call. Attend Al-Anon meetings often. I share this with my clients all the time. When in doubt, go to a meeting. I was only able to go to an Al-Anon meeting once this week. Okay, well, did you get mad at your family member once this week? No, it was a lot. Okay, well, maybe we should try going to meetings a lot too. And it works. My sponsor also taught me, and I knew this from reading the books, but my sponsor showed me what it looked like, is that compassion is free for anyone who chooses to use it. And that trust and love doesn't come from anyone else until it comes from within. It starts with us. And that's why I like the declaration that I shared with you in the beginning, is let the hand of Al-Anon start with me. Let it start with me. And of course, keep it simple. We learn before we behave or before we say anything to ask ourselves simple questions. This is the acronym that you guys all saw in your apps. First question is, is it thoughtful? Is it thoughtful? Before I say anything, I ask myself, is what I'm about to say thoughtful? It reminds me of this lesson from program, which is I would not love my family member any less if they were diagnosed with cancer. I would not tell them that they chose cancer over me. And sometimes the most thoughtful thing we can do for the alcoholic or addict in our life or in our clinical practice is to remember that they do not choose the disease. They did not choose it. The disease of alcoholism is not personal. This is when, we had the question earlier, right? This is what our clients learn over time, is that the disease of alcoholism was never personal. No one was trying to hurt them. In fact, the people who are affected by the disease, oftentimes when they get recovery, those are their biggest amends. They don't want to be hurting anyone else. Most people, well, I'll say this without any, this one's not academically rigorous, but people are good. People are good. They don't want to be hurting others. And we've got to remember that when we see the alcoholics in our clinical practice and in our lives, they're not trying to hurt us. And the disease isn't personal. And it is treatable on both sides. We then ask ourselves, is it honest? And here's where it gets interesting because I need a couple volunteers who aren't afraid of chocolate or aren't allergic. Chocolate and wafers, really. One, two, three volunteers. Anybody want some chocolate? We've got one. Anyone else? No, you sure? Oh, we got two. We got them, ladies and gentlemen. Oh, we got three. Too good. I'm not participating, but I'm actually abstaining from sweets. Oh, okay. All right. I can take the chair. Okay. Thank you. Probably need one more. That's good. Thank you. No worries. Will that still work for the? No, no, no. Just go ahead and eat those while we continue. Now, my father grew up in Texas and in Texas, lives were called whoppers, which is why I brought whoppers. In program, we're introduced to honesty right at the jump, right? We're asked to admit powerlessness, right? I'm powerless over the alcoholic in my life. And for the alcoholic, they're powerless over alcohol. And as we continue to go through, you lay a foundation of spirituality, right? That you get to define for yourself. And then you do a fearless and moral inventory where you're rigorously looking at yourself and all of your wrongdoings. And then you share it with people. That's the part that terrified me in my own step work, since I've shared with you a lot of personal things here today. Sharing my inventory. I often, I would hear people in program often share, I shared things that I thought I was gonna take to the grave. And I felt that, right, in my step work. And you're prompted to share it, not only with yourself by writing it on paper, but to share it with your higher power and to share it with a trustworthy individual. And we do so as honestly as possible. And the reason we do that is because, well, we used to tell a lot of lies. And I'm sorry, what was your first name? David. David and? Bob. Bob and? Sarah. Sarah, David and Sarah. How are the Whoppers? They were good? Maltesers? No. Are they better? Yeah. I was going to ask you, can I have them back? No? Did you eat them? Yeah. I thought so. This is what happens when we tell a lie. Once you've told a lie, you can never take it back. Once it's out, there it is. Notice when I asked them for the Whoppers back, they ate them. They ate it up. I wanted it back, but they had already eaten the Whoppers. As we look at it, in our lives, when someone tells us a lie and then we find out that it's a lie, how does that feel? It gets sick to your stomach. It's fun and games in here, like obviously you knew something was coming. But in our personal lives, when someone lies to us and we find out it's a lie, it kind of sucks. Like Sarah was saying, it makes us sick to our stomach. How do you think they feel? Same. I knew, and I've been planning this talk for a while, and I knew I was going to ask you for those Whoppers back. This is all just to highlight an intervention, but I was still nervous to ask you for it back. Now imagine if I had actually told you a lie. Do you have a question? Well, it's not the same. The person who tells a lie does not feel the same as the person who is lied to. Say more. What might they feel? The person who told the lie, they hate themselves. The person who lies to you, you lie. We kind of don't like them, but they don't like themselves. It's a mirror image, but it's not the same. Yeah, you're absolutely correct. Wouldn't it be fair to say that the person who's telling the lie might be struggling with a low self-esteem issue? I'll give you a classic example. An individual will often, when they experience low self-esteem, tell a lie to make themselves look better. Have we witnessed that in our lives? When the individual, the 12-stepper, starts to take the inventory of looking at their behaviors honestly and admitting places that they've lied, they oftentimes are in situations where later on in the steps they're prompted to go and make amends. They have to go to their loved ones and ask for these things back. Trust back. Now, if I were to say, hey, David, do you want another chocolate? Would you trust me? Not sure. What could I do to get you to trust me again? Not much. The only thing that maybe, theoretically, that could work is if I gave chocolate to somebody else and didn't ask it back from them. In order for me, on my end, feeling terribly about my lie, to change my behaviors, to be more honest, would be to engage with other individuals in a healthy manner. Whether or not the person who I lied to before sees it, I see it. This is recovery. My job, and I thought it was brilliant that you brought up this point, is that it's similar, but it's a mirror image, but it's not the same. It requires me to change my behavior, not so that that person who I wronged before trusts me again, but so that I can trust myself, so that I'm not going around lying to people anymore. That's what recovery is, in a nutshell, is owning our behaviors. This is what our clients find in those rooms. That's what helps them be more honest with themselves and with us as clinicians and with their loved ones, but I would say, most importantly, with themselves. When I asked that question of how might that individual feel, it wasn't to gain sympathy for the person who was lying. It was to highlight how difficult it is when individuals are attempting to change their behaviors. Imagine you don't even know that there's a program to help you. A lot of people, this is why they come into clinical settings feeling so unwanted, unloved, and alone. This is why they're in a desperate place, because they know they've been lying, at least to themselves. Here's the biggest lie that the family member or friend of an alcoholic tells themselves, is that this person who is using, who I love, is going to get better. Well, how do you know that? If that person is still using, how do you know? It's the biggest lie that we tell ourselves, or here's the other biggest lie, is that I can do something to help that person get better. These are the things that we unravel, so that we're not behaving and speaking in ways that aren't true for ourselves anymore. We're not making other people feel uncomfortable by giving whoppers and expecting them back. That's another salient point, is when we tell a lie and then we want to take it back, there's a certain expectation involved. Well, they haven't consumed that in a way that is irreconcilable. My expectation, asking for the chocolate back, would be, well, I'm expecting that they haven't eaten the chocolate yet, even though I just told them to eat the chocolate. Expectations will get you in trouble, and they lead to resentments. We're looking at it in the context of a piece of chocolate, but in recovery and in the alcoholic home, essentially what we're looking at is when someone tells us a truth or a lie with their behavior, there has to be a lot of expectation on the other person to assume that now everything is going to unfold in a healthy way. When somebody is drinking in the environment and I believe that I can help them with their drinking and now I'm pissed at them for their drinking, but I'm not telling them that I'm pissed at them for their drinking, well, I'm not telling the truth, am I? I have a lot of expectations on that person to be getting better, but they're not getting better. I'm not telling them that I'm that pissed at them. Recovery cleans all of that up. It keeps me, it keeps our clients from telling the lie in their behaviors. That and also verbally, but that's more nuanced. We would leave that to the discretion of every clinician in this room when a client shares with you the versions of lies that they've told and every client has them. The program helps them sort it out. We learn before we behave or respond in a situation in step 10, we learn to ask ourselves, is what I'm about to say or do honest? Is it honest for me? Any questions on that or comments from David or Sarah? And there's a better chocolate out there too. Thank you both for participating in that. Any other questions or comments so far? So self-esteem is the culmination of self-care, self-care, self-care, self-care, self-care, self-control, self-love, self-compassion, self-confidence, and that all those self-things, all those things that are the way that we treat ourselves is, it's a lot of work. It's a lot of work to have self-respect, self-trust, self-care, self-confidence, and when those things happen, then esteem is not the problem, right? Because you've done the work. Yeah. Well, here's an interesting point to what you were sharing. Your first name is, I'm sorry, Brent. Thank you, Brent. Spirituality is a big part of program, right? It's not a religious program, all right? Twelve Steps aren't. They're often held in religious centers mostly because the rent is cheap and places like that, but it's a spiritual program. And what you'll see in the literature for Al-Anon AA oftentimes is that we were filling with our behaviors a God-shaped hole. However you want to identify God, some people identify God as this chair right here in front of me. I'm not here to tell you who or what God is, but what I'll tell you is that people are finding solution for the esteem conversation we're having through a connection to something bigger than themselves. The agnostics in the room often refer to the group as the higher power, right? A place where they're receiving information that didn't come from them, all right? And I think, you know, I know a lot of clinicians who view it in that way and I would agree scientifically, right? They're observing behaviors that aren't from within, all right? And it's showing them they're not alone, all right? And when we find ourselves in a situation much like the story from earlier of the greeter that saved a client's life, when we can feel welcomed, right, and understood and heard, right, which is kind of the pillars of what we do clinically, that's going to build a lot of esteem, right, in our behaviors. Not to the point where like, oh, I need this self-esteem, but to the point where I can look at myself in a respectable way and make healthier decisions because, well, it's worth doing so. Because if these other people are doing it, why can't I, right? And I think a lot of people find that support first before they trust it in others. They may find it from a higher power or vice versa, right? I mean, there's no right or wrong answer there. Is it intelligent? And so we learn to ask ourselves, is it intelligent? This one is subjective, right? But I'll share a little snippet with you is according to an article called Where Did My IQ Points Go? in Psychology Today, when we get angry, the light goes out in the prefrontal cortex, which is the executive functioning and decision-making region of the brain. It's like we're operating with 10 to 15 less IQ points when we're angry, right? Not so directly as that, but that's what it may feel like. If we work on changing the way we think about situations that anger us, we'll find in time that anger no longer controls us. This is the best way to help ourselves make smart, effective decisions in anger-inducing situations instead of ineffective and unhelpful ones. So like we touched on earlier in some of the symptoms that may present in the friend or family member of the alcoholic, oftentimes they're resentful, right? Because they can't control or change the alcoholic's behavior, right? And they get angry. And so now they're not reasonably responding with, let's just say, helpful responses in a situation because they're angry. But what we all know underneath anger is hurt, injustice, fear, and real or perceived attacks on self-esteem, or real or perceived threats to your physical or corporal body, right? And so in a lot of these environments in the alcoholic homes, all of those things are true. So it's not so much that the person is just angry and they're not making intelligent responses, it's because they're feeling hurt. And well, as humans, I think we can all acknowledge that when we feel hurt, we don't respond in the most helpful ways, right? And that would be why we lean on the behaviors that we're talking about and asking ourselves these questions and stepping away from the situation to think so that we don't respond with unhelpful responses. Because when we are angry or feeling hurt, we may say things that we don't mean. And in program, we really do emphasize, we try to keep it really simple. When you're angry or feeling hurt, step away, right? Ask yourself this question again, is what I'm about to say or do intelligent? Would an intelligent person do this? If the answer to that is no or you can't find the answer, then call someone who you think is intelligent and ask them. It's not who's smart here, it's really just another reminder to talk to good people who can help you reason things out. Is it necessary? Here's three really simple, important questions that can slow things down for your clients. Does it need to be said? Does it need to be said right now? Does it need to be said by me? If the answer isn't yes to all three of these questions, I often will tell my clients, you know, when they're kind of processing these situations or responsees of mine, don't say it, all right? If you don't have a yes to these questions, don't say it, all right? You'll save yourself a lot of grief. If we remember, right, from the wise words from sponsors, never miss a golden opportunity to shut up, all right? It really is that simple. For a lot of our clients, it really is that simple. And I want to remind of that framework is we've got people coming into our rooms who are in distress, feeling desperation, and they're making desperate decisions. And recovery in the beginning oftentimes is removing them from making desperate decisions, giving them really simple, effective skills, all right? That's what recovery provides to our clients is why it's so important. It keeps it really simple for people who are coming in in distress, all right? These are three really simple questions that can help slow down a response or behavior that someone may regret later on. And the final question is, is it kind? I'm going to share with you just a quick anecdote of an individual in program who, for the sake of this, I'll call him Angel because he really has been an angel in my life. And I'll have you know that when I shared with him and requested sharing a bit of his story, he was ecstatic that I was going to share it with medical and mental health professionals. Angel is a member who has been in Al-Anon for 15 years and he's on the spectrum. He was a greeter in my first meeting. And I'm a tall guy. I'm 6'5", but he's 6'7", all right? And he's a big guy and he is very clearly with his behaviors and has a very hard time controlling himself in social settings. But he's been in this men's group for 15 years. And I think because I was also a large human, when I first came in, he gravitated to me. And I started in my third or fourth week doing the greeter position with him. But this is not why I share the story of kindness through Angel. What I witnessed in that men's group was something that I won't say like changed my life. It just further reinforced early in my program that I was in the right place. I saw a group of men who embraced someone that was different from them. Now I grew up playing baseball for 19 years. And if you were different from us, you have the problem, all right? That's kind of how athletics work, kind of in a nutshell, not to make it kind of morbid, but it's like if you don't get on board with what we're doing, get out of here, all right? And then I find myself after my baseball career is over and in my clinical career, walking into a room full of men who embrace differences. It was such a culture shock for me. I find myself, and I think all of us can relate to this in this room, we're pretty open people by nature. It's why we do what we do. But to be surrounded by people who for no reason other than just being a good person except someone that's so different, it touched my heart. And I often, I often think about Angel when I ask myself is what I'm about to say kind, right? Because if I was in another environment and I said something that wasn't kind, would I hurt someone that I didn't know was struggling in the way that Angel's struggling, all right? Here's an example that we often use in recovery is that you'll hear a lot of non-clinical individuals say that the measure of a person's mental health is the five feet of road stretched out in front of them. It's like when someone cuts you off, are you flipping them off or yelling at them, all right? Or are you just letting them go? And the reason it's a good measurement is because, well, maybe that person is having a bad day. Maybe there's an emergency maybe dinner is burning in the stove. Maybe they're taking their dog or their cat to the vet. You don't know what's going on for other people. And when I think of Angel and this men's group, all right, the point of the El Pollo Loco is he loves, this is like his obsession, he loves El Pollo Loco. Every time we see him, he has to mention it. And we all, it touches my heart because about a year and a half in, we all, for his birthday, we took him to El Pollo Loco. And it's little things like that that I didn't have prior to program, right? And that a lot of my clients over the years have shared with me that they didn't have prior to program. Not just because of this situation, Angel has his limitations and that makes it a little more special, but because we all come in in different places and no matter where you're coming from, you're going to be greeted with kindness. And it's why I come to places like this and talk to esteemed mental health and medical professionals about this information. Because if someone who's struggling in the ways that Angel has in his life, right, in the ways that he's even able with his, you know, being on the spectrum and still able to open up in Al-Anon meetings, people need to know about this stuff, right? And I'm just watching it change people's lives. I think as we draw to a close here, I'm really just finding myself wanting to close it with like, everything I shared with you, we need more research on, right? And I wish that this room for a topic like this was packed, but I think a passion that we can all share is that if there's a place that exists for our clients who may possibly, even if it's a small percentage of them, right, can find thoughtful, honest, and kind people, right, who are going to teach them how to do that coming from the environments that they came from, where they were around people who weren't thoughtful, weren't honest, and weren't kind to them, right, wouldn't it be helpful to send them in that direction? I'll close with that and any other questions. I was wondering if you could comment on how this approach to either people who are using substances or their families can be used in general psychotherapy for people for whom substance use is not an issue, either in themselves or in their family. Yeah, absolutely. I use these techniques often with clients who have no 12-step recovery background or no substance background. I guess the best way I can kind of address that in a nutshell is I often utilize the skills of detachment, right? So if, let's put it like this. In 12-step programs, you have step one, which is admitted powerless over alcohol, and our lives have become unmanageable. The place I'll start, let's say like with a family who's struggling with a loved one who has bipolar or has schizophrenia is I'm powerless over schizophrenia, and my life has become unmanageable, right, trying to help fix or save this person or try to get them in all the right appointments and get them to the right doctors, right? It has the same amount of stress, right? And so it's not, you know, especially with like primary mental health, it's not to get the family so detached because oftentimes they need that support and that's the most supportive person in their life, but it's really just to open the same door for those family members of like there is support for you too, and in this dynamic, even though you may be that support, you also need to take care of yourself. And then we build it from there. Yeah, thank you. Yeah, yeah, it's kind of a colloquial recovery thing is the measure of a person's mental health is the five feet of road stretched out in front of them when they're driving. So if someone cuts you off and you're flipping them off, you probably have something to talk about in therapy. Cool. Thank you.

Alan Hyde

marriage therapist

family therapist

Southern California

12-step program

Al-Anon

alcoholism

codependency

recovery programs

family dynamics

generational cycles

mental wellness

THINK acronym