By Michael G. Brock
This piece was written after the death by overdose of Actor Phillip Seymour-Hoffman and concluded before the suicide by comedian Robin Williams. Both of these talented men relapsed after two decades of sobriety in a 12-step group. While substance abuse was the direct cause of death in Hoffman's case, it would be difficult to say without more information if Williams' relapse in 2006 in some way exacerbated the problems with depression that eventually led to him taking his own life.
Regardless, both of these deaths reinforced for me the danger of encouraging substance abusers to moderate their use of alcohol or other addictive substances. It is a very slippery slope, and dangerous to the point of recklessness on the part of any mental health professional to say that an addict can be taught to use a drug in moderation. If there are some who succeed in doing so, they are merely the exception that proves the rule. Most addicts have tried dozens, if not hundreds of times to moderate their use of substances on their own or with the help of health care professionals, but to no avail.
Subsequent to Hoffman's death, there was a short article in Time Magazine from a fellow 12-step member regarding a conversation they had while working on a film together. He quoted Hoffman as saying that if one of them did overdose it would probably save other lives who would be cautioned by their example. That this represents dangerously convoluted thinking requires no clarification for the sane and sober. To paraphrase a famous quote by Gen. George Patton, "No poor, dumb SOB ever got anyone else sober by dying of an overdose; he did it by staying sober."
Strangely, William's case is for me more disturbing; not just because he took his own life, but because he may have been getting treatment for the wrong condition. Shortly before his suicide he was treated at Hazelden, a 12-step treatment facility. If he was using, the treatment was appropriate, but if he wasn't, he probably should have been hospitalized for depression.
The 12 steps are not a cure-all for anything that ails one. Major Depression has its own symptoms and its own treatments, including therapy and effective medications. What it does not have is the kind of mutual help support group that recovering alcoholics have; the kind that Abraham Low tried to build and almost succeeded.
Sadly, there is no mental health equivalent for 12-Step programs today, though the need is as great as ever. Actually, it is greater than ever, since the insurance industry has been completely taken over by accounts who were quick to recognize that there was no profit in treating mental health or substance abuse issues, and few people really care whether these populations get any help at all.
That a book such as Dr. Dodes could even get published today is a testament to the lack of alternatives that leave the courts with few options: do we put everyone who commits a minor crime related to substance abuse in jail, or do we try to address the root of the problem? The existence of drug courts and the prevalence of referrals to either publically funded (probably AA based) therapy or AA, shows that the courts get it; they are looking for realistic solutions.
In seeking these solutions, they have made therapists and 12-Step groups there unwitting (and in some cases, unwilling) allies in the disposition phase of the criminal justice system. But this is unlikely to change any time soon. The idea that judges are going to take Dodes up on his proposal that they instead refer cases to $300 dollar an hour insight-oriented therapists with a track record of failure for treating addiction, vs something that is free and has a chance of success is so stupid it is laughable.
The only reason a book like this could even get published today is the resentment engendered by the fact that 12-Step groups are being utilized as a resource by the courts; as long as AA was a completely voluntary venture, no one had any reason to resent it. Even churches, who could have seen AA as competition, were so happy to have a promising resource that they opened their doors to AA for a meeting place. They could offer their members and troubled loved ones something that might provide a solution for them, and certainly provides an answer for many with addiction issues. They could see this with their own eyes.
Therapy has something to offer, and need not be in completion with other resources. Most addiction problems are impacted by a combination of treatment, self-help and medical resources. A large number of recovered addicts and alcoholics utilized therapy as a growth tool in recovery, as do many who have had neither problem. It is an accepted resource today and a valuable one to anyone who seeks to understand their decision making process, and to make better ones.
But to foster resentment as a means of furthering one's own ends, and to ultimately have no realistic alternative solutions to offer is to be part of the world's ills, not part of its cure, and is a goal that no one who wishes to be taken seriously should aspire to.
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Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; 313-802-0863, fax/phone 734-692-1082; e-mail, michaelgbrock@ comcast.net; website, michaelgbrock.com.
Published: Wed, Apr 20, 2016
