Step One of Alcoholism Treatment
Creating a loving atmosphere in step one alcoholism treatment
By Robert R. Perkinson, Ph.D.
No one likes to admit defeat. Our minds rebel at the very thought that we have lost control. We are big, strong, intelligent, and capable. How can it be that we are powerless? How can it be that our lives are unmanageable? This exercise will help you to sort through your life and make some important decisions. Answer each question that applies to you as completely as you can. This is an opportunity for you to get accurate. You need to see the truth about yourself.
Let’s pretend for a moment that you are the commander in a nuclear missile silo. You are in charge of a 10-megaton bomb. If you think about it, this is exactly the kind of control you want over your life. You want to be in control of your thinking, feeling, and behavior. You want to be in control all of the time, not just some of the time. If you do something by accident or do something foolishly, you might kill a lot of people. You never want to be out of control of your behavior, not even for a second.
People who are powerless over alcohol or drugs occasionally will be under the influence of the chemical when they are doing something physically hazardous. They may be intoxicated or hung over when they are at work, using dangerous equipment, or driving. About 25,000 Americans are killed each year driving while intoxicated. If you have ever done anything like this, then you have been out of control. You have risked your own life and the lives of others. Surely you cannot drive better when you are intoxicated than when you are sober. Now it is time to get honest.
1. Have you ever been intoxicated when you were doing something dangerous? For example, have you ever driven a car when you were using? Give some examples.
2. Did you think that you were placing your life and the lives of others in jeopardy? What were you thinking?
3. Whose lives did you risk? Make a list of those people you endangered.
4. How do you feel about what you did?
People who are powerless occasionally will do things while intoxicated or hung over that they feel bad or guilty about later. They might act foolishly at a party, act out sexually, get angry, or say things they do not mean. Have you ever done anything while intoxicated that you felt guilty or bad about later? Make a list of the things that made you feel the most uncomfortable.
People who are powerless gradually will lose respect for themselves. They will have difficulty in trusting themselves. In what ways have you lost respect for yourself due to drug or alcohol use?
People who are powerless will do things that they do not remember doing. If you drink enough or use enough drugs, you cannot remember things properly. You might have people come up to you after a party and tell you something you did that you do not remember doing. You might wake up and not know where you are. You might not remember how you got home. This is a blackout, and it is very scary. You could have done anything. Most blackouts last a few minutes, but some can go on for hours or days.
1. Describe any blackouts you have had.
2. How does it feel to know that you did something that you do not remember?
3. Think for a minute of what you could have done. You could have done anything, and you would not have known it.
People who are powerless cannot keep promises that they make to themselves or others. They promise that they will cut down on their drinking, and they do not. They promise that they will not use, and they do. They promise to be home, to work, to be at the Cub Scout meeting, or to go to school, but they do not make it. They cannot always do what they want to do because sometimes they are too intoxicated or hung over. They disappoint themselves, and they lose trust in themselves. Other people lose trust in them. They can count on themselves some of the time, but they cannot count on themselves all of the time.
1. Did you ever promise yourself that you would cut down your drug or alcohol use?
2. What happened to these promises?
3. Did you ever promise yourself that you would quit entirely?
4. What happened to your promise?
5. Did you ever make a promise to someone that you did not keep because you were intoxicated or hung over? Give a few examples.
6. Are you reliable when you are intoxicated?
People who are powerless have accidents. They fall down, or have accidents with their cars, when they are intoxicated. Evidence proves that drugs profoundly affect thinking, coordination, and reaction time. Have you ever had an accident while intoxicated? Describe each accident.
People who are powerless lose control of their behavior. They do things that they would not normally do when they are clean and sober. They might get into fights. They might hit or yell at people they love—a spouse, child, parent, or friend. They might say things that they do not mean.
Have you ever gotten into a fight when you were intoxicated? Describe each instance.
People who are powerless say things that they do not mean. They might say sexual or angry things that they feel bad about later. They might not remember everything they said, but the other people do remember. Have you ever said something you did not mean while intoxicated? What did you say? What did you do?
People are powerless when they have feelings that they cannot deal with. They might drink or use drugs because they feel frightened, angry, or sad. They medicate their feelings. Have you ever used drugs to cover up your feelings? Give a few examples.
What feelings do you have difficulty dealing with?
People are powerless when they are not safe. What convinces you that you no longer can use drugs or alcohol safely?
People are powerless when they know that they should do something but they cannot do it. They may make a great effort, but they just cannot seem to finish what they started out to do.
1. Could you cut down on your drug or alcohol use every time you wanted and for as long as you wanted?
2. Did being intoxicated or hung over ever keep you from doing something at home that you thought you should do? Give some examples.
3. Did being intoxicated or hung over ever keep you from going to work? Give some examples.
4. Did you ever lose a job because of your drinking or drug use? Write down what happened.
People are powerless when other people have to warn them that they are in trouble. You may have felt like you were fine, but people close to you noticed that something was wrong. It probably was difficult for them to put their finger on just what was wrong, but they were worried about you. It is difficult to confront someone when the person is wrong, so people avoid doing so until they cannot stand the behavior anymore. When addicts are confronted with their behavior, they feel annoyed and irritated. They want to be left alone with the lies that they are telling themselves. Has anyone ever talked to you about your drinking or drug use? Who? How did you feel?
People are powerless when they do not know the truth about themselves. Addicts lie to themselves about how much they are drinking or using. They lie to themselves about how often they use. They lie to themselves about their problems, even when the problems are obvious. They blame others for their problems. Here are some common lies they tell themselves:
“I can quit anytime I want to.”
“I only had a couple.”
“The police were out to get me.”
“I only use when I need it.”
“Everybody does it.”
“I was drinking but I wasn’t drunk.”
“Anybody can get arrested for drunk driving.”
“My friends won’t like me if I don’t use.”
“I never have problems when I drink beer.”
“I won’t drink until after 5 o’clock.”
“From now on, I’ll only smoke pot.”
“I’m going to cut down to five pills a day.”
Addicts continue to lie to themselves to the very end. They hold onto their delusional thinking, and they believe that their lies are the truth. They deliberately lie to those close to them. They hide their use. They make their problems seem smaller than they actually are. They make excuses for why they are using. They refuse to see the truth.
1. Have you ever lied to yourself about your chemical use? List some of the lies you told yourself.
2. List the ways in which you tried to convince yourself that you did not have a problem.
3. List some of the ways in which you tried to convince others that you did not have a problem.
Imagine that you are the manager of a large corporation. You are responsible for how everything runs. If you are not a good manager, then your business will fail. You must carefully plan everything and carry out those plans well. You must be alert. You must know exactly where you are and where you are going. These are the skills you need to manage your life effectively.
Chemically dependent persons are not good managers. They keep losing control. Their plans fall through. They cannot devise and stick to things long enough to see a solution. They are lying to themselves, so they do not know where they are and they are too confused to decide where they want to go next. Their feelings are being medicated, so they cannot use their feelings to give them energy and direction for problem solving. Problems do not get solved; they escalate.
You do not have to be a bad manager all of the time to be a bad manager. It is worse to be a bad manager some of the time. It is totally confusing. Most chemically dependent persons have flurries of productive activity when they work too much. They work themselves to the bone, and then they let things slide. It is like being on a roller coaster. Sometimes things are in control; sometimes things are out of control. Things are up and down, and they never can predict which way things are going to be tomorrow.
People’s lives are unmanageable when they have plans fall apart because they were too intoxicated or hung over to complete them. Make a list of the plans you failed to complete because of your chemical use.
People’s lives are unmanageable when they cannot manage their finances consistently.
1. List any money problems you are having.
2. Are any of these problems the result of your chemical dependency? Explain how chemicals have contributed to the problems.
People’s lives are unmanageable when they cannot trust their own judgment.
Have you ever been so intoxicated that you did not know what was happening? Explain.
Did you ever lie to yourself about your chemical use? Explain how your lies contributed your being unable to manage your life.
Have you ever made a decision while intoxicated that you were sorry about later? Explain.
People’s lives are unmanageable if people cannot work or play normally. Addicts miss work and recreational activities because of their drug use. They make excuses, but the real reason that they missed these events was they were too intoxicated or hung over.
Have you ever missed work because you were too intoxicated or hung over? List the times.
Have you ever missed recreational or family activities because you were too drunk or hung over? List the times.
People’s lives are unmanageable if they are in trouble with other people or society. Chemically dependent persons will break the rules to get their own way. They have problems with authority.
Have you ever been in legal trouble when you were drinking or using drugs? Describe the legal problems that you have had.
Have you ever had problems with your parents because of your drinking or using drugs? Explain.
Have you ever had problems in school because of your chemical use? Explain.
People’s lives are unmanageable if people cannot consistently achieve their goals. Chemically dependent people reach out for what they want, but something keeps getting in the way. It does not seem fair. They keep falling short of their goals. Finally, they give up completely. They may have had the goal of going to school, getting a better job, improving their family problems, getting in good physical condition, or going on a diet. No matter what the goals are, something keeps going wrong. Chemically dependent people always will try to blame other people, but they cannot work hard enough or long enough to reach their goals. Alcoholics and drug addicts are good starters, but they are poor finishers.
List the goals that you had for yourself that you did not achieve.
People’s lives are unmanageable if people cannot use their feelings appropriately. Feelings give us energy and direction for problem solving. Chemically dependent people medicate their feelings with drugs or alcohol. The substance gives them a different feeling—a chemically induced feeling. Chemically dependent people become very confused about how they feel.
What feelings have you tried to alter with the use of chemicals?
What feelings does your drug of choice create? How do you feel when you are intoxicated or hung over?
People’s lives are unmanageable if they violate their own rules or when they violate their own morals and values. Chemically dependent persons compromise their values to continue using chemicals. They have the value not to lie, but they lie anyway. They have the value not to steal, but they steal anyway. They have the value to be loyal to their spouses or friends, but when they are intoxicated or hung over, they do not remain loyal. Their values and morals fall away, one by one. They end up doing things that they do not believe in. They know that they are doing the wrong thing, but they do it anyway.
Did you ever lie to cover up your chemical use? How did you feel about yourself?
Were you ever disloyal when using chemicals? Explain.
Did you ever steal to get your drugs? Explain what you did and how you felt about yourself later.
Did you ever break the law when intoxicated? What did you do?
Did you ever hit someone you loved while intoxicated or hung over. Explain.
Did you treat yourself poorly by refusing to stop drinking or using drugs? Explain how you were feeling about yourself.
Did you stop going to church? How did this make you feel about yourself?
People’s lives are unmanageable when they continue to do things that give them problems. Chemicals create physical problems, headaches, ulcers, nausea, vomiting, cirrhosis, and many other physical problems. Even if chemically dependent persons are aware of physical problems caused by chemicals, they keep on using anyway.
Chemicals cause psychological problems. They can make people feel depressed, fearful, anxious, or overly angry. Even if alcoholics or drug addicts are aware of these symptoms, they will continue to use.
Chemicals create relationship problems. They cause family problems such as family fights and verbal and physical abuse. They cause interpersonal conflicts at work, with family, and with friends. Chemically dependent persons withdraw and become more isolated and alone. Even if they believe that the alcohol or drugs cause the problems, they continue to use.
Did you have any persistent physical problems that were caused by your chemical use? Describe the problems.
Did you have any persistent psychological problems, such as depression, that were caused by your chemical use? Describe the problems.
Did you have a persistent interpersonal conflict that was exacerbated by your chemical use? Describe this problem.
You must have good reasons to work toward a clean and sober lifestyle. Look over this exercise and list 10 reasons why you want to continue to remain clean and sober.
After completing this exercise, take a long look at yourself.
1. Have there been times when you were powerless over drugs or alcohol?
2. Have there been times when your life was unmanageable?
If you are unable to stay sober on your own, you are going to need some kind of treatment. If this happens, call us at 800-992-1921 for a free assessment. We will make sure that you get into the treatment that you need at a price you can afford. If you are unable to stay sober on your own, you are going to need some kind of treatment. If this happens, call us at 800-992-1921 for a free assessment. We will make sure that you get into the treatment that you need at a price you can afford.
Our Location: Keystone Treatment Center, 1010 East Second Street, Canton, SD 57013
Call 1-800-992-1921 for a free assessment
Chemical Dependency Counseling: A Practical Guide, Fifth Edition: is a best-selling comprehensive guide for counselors and front-line professionals who work with the chemically dependent and addicted in a variety of treatment settings. The text shows the counselor how to use the best evidence-based treatments available, including motivational enhancement, cognitive behavioral therapy, skills training, medication and 12 step facilitation. Guiding the counselor step-by-step through treatment, this volume presents state-of-the-art tools, and forms and tests necessary to deliver outstanding treatment and to meet the highest standards demanded by accrediting bodies.
The Alcoholism and Drug Abuse Client Workbook, Third Edition:An evidence-based program that uses treatments including motivational enhancement, cognitive-behavioral therapy, skills training, medication, and 12-step facilitation. It provides a venue for clients to write down their thoughts and experiences as they progress through treatment.
The Gambling Addiction Client Workbook, Third Edition:An evidence-based program that uses treatments including motivational enhancement, cognitive-behavioral therapy, skills training, medication, and 12-step facilitation. This workbook walks clients through self-reflective activities and exercises meant to help them recognize the underlying motivations and causes of their gambling addiction and to learn the tools necessary for recovery. The Third Edition of this workbook includes coverage of all 12 steps of recovery. Chapters focused on honesty and relapse prevention as well as a personal recovery plan contribute to client success.
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Treating Alcoholism provides a complete road map for assessing, diagnosing, and treating this multifaceted and tenacious illness. Detailed clinical information on the disease accompanies ready-to-use tools for practice. With a special emphasis on the 12 Steps of Alcoholics Anonymous, the author walks you through the first five steps of this established methodology in comprehensive detail, showing how to easily apply each one to treatment.
The Big Book of Alcoholics Anonymous says that only God can relieve the illness of addiction. Here are a few spiritual tools to help you:
God Talks To You: Second Edition:Teaches you how to hear God's voice and details the spiritual path forward. Includes spiritual tests, prophets, prayer, meditation, contemplation and how to find a spiritual friend.
Peace Will Come CD Sit back and let the words and music sink into your soul. Come back often and play the songs over and over again. You won't be sorry. God will teach you many things you need to know.
A Communication From God: A meditation tape that will give you long communications from God. The tape takes you through two exercises where God speaks to you directly.
Addiction stops your spiritual progress.
Begin a new spiritual journey:www.godtalkstoyou.com
Read the latest research for a school paper or project from the National Library of Medicine