Sunday, August 9, 2009

My neighbor V.

LifeRing convenor Lorne from Montreal (see recent post about diehards) adds a P.S. to his message:

My neighbour V__ came over at 9 am already sloshed with a bottle of beer in his hand claiming all the while he wished he could stop. I showed him the Lifering brochure .... He started going to see a psychologist. He thinks beer is not "alcohol".

I really don't know how to help V__, he knows he has a problem, but can not take in the info. He doesn't think it's so easy to just stop cold turkey like that but is always asking me how does one live without the use of drugs. And I have to admit, between you and me that I find it hard to see V__'s "Sober Self", in fact I have rarely seen it when he is sober.

No, that is not true, V__'s Sober Self must be what I have seen on the rare occasions I've seen him sober, when he doesn't need anything from anyone else, much less company to cry in his beer with, on which occasions he definitely does not consider he has a problem!

It sure comes out different when you factor into the equation a real person you know, not "Sober Self", but V__'s Sober Self. I feel inadequate at not being able to see my neighbour's "Sober Self".

Am I blind? Because it is precisely for people like him that I want to start up Lifering here.
These are great questions. There's no doubt that learning to see the sober self, the S, in a person who is still actively drinking, is a cognitive challenge. We may well ask ourselves if we need new glasses, or if the whole theory is just a fantasy.

To begin with, if V is still alive -- and we know he is, because he is talking with Lorne -- then we can be sure that he has a sober self. If his inner addict self, his A, occupied 100 per cent of his psychic space, then Lorne would probably not be talking. The prime directive of the A is to drink and/or use drugs. The A knows no limits. Its thirst has no bounds. If a person is 100 per cent A, and is not locked up, then it's only a matter of time and money before they drink themselves to death or die of an overdose. Since V is drinking already in the morning, he is in considerable danger of sliding in that direction, and you would be quite right to assume that his S exercises very limited influence.

Still, V is alive. That means he stops drinking at certain points, and perhaps on certain days, and he limits himself (apparently) to beer, which means that he is less likely to fall into an alcoholic coma and suffer cardiac arrest than a person who drinks hard liquor. You can see the influence of the S, which is rooted in the survival instinct, in this choice of beverages. And, as Lorne observed, there are some days when V appears sober and somewhat rational. So there is an S.

We mustn’t assume that the sober self has already reached the stage where the person is able to articulate their sober strivings in a consistent way, and, even more, take decisive action such as to come to a meeting.

If you’re acquainted with the Prochaska/DiClemente Stages of Change model, you’ll know what I’m talking about. Neighbor V sounds like his S is in what Prochaska/DiClemente call the precontemplation stage. Or maybe V's sober self is already in the contemplation stage, since he’s seeing a counselor and talking with Lorne who, he knows, is alcohol-free and a recovery activist. V is "thinking" about quitting, but his thinking is still up in the purely verbal mode, really more of a pose than a real thought, and it doesn't have a solid connection to action.

In that stage Lorne will probably not have success getting the person to come to a meeting, except maybe once out of curiosity (to be followed by non-attendance). To the extent that you are able to engage in continuing dialogue with the person, which is very good for him, your method should be Socratic and your goals should be to stir up the thinking and questioning processes. In Motivational Interviewing they call this “developing discrepancy.” It means, to help the person become more aware of the contradictions between what they believe they are doing and what they are actually doing, between their professed goals and their current actions – in other words, between their S and their A. Eventually, in time, if other circumstances are favorable, the person’s S will progress to the action stage.

I personally would not build my strategy for creating LifeRing meetings on the hope of attracting and retaining people who are in that pre-action stage of development. Coming and returning to a meeting, any meeting, is an ACTION. Recovery support meetings are created and sustained by people whose S has reached the action stage.

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