Helping the self without cocaine

HELPING THE SELF WITHOUT Review of‘Cocaine Solutiom: Hel$,for Cort~ine Abuse Rice-Licare and Katharine Delaney-McLaughlin. 1990. PETER

COCAINE

and Th& Fumilia New York:

by Jennifer

Haworrh

Press,

PROVET

Phoenix House, 164 West 74th Street, New York, NY 10023, LJ.S.11.

Cocaine

Solutions:

Help fo?- C‘oraiiw

Abuses

ad

TIwi~ Fnwrihs

is a concrete,

direct,

and useful book on the multitude of problems associated with cocaine abuse today. The authors are firmly grounded within one track of the self-help movement. ‘I-his is evident from the Prologue where they identify themselves as “recovered drug addicts” and reprint the twelve steps of Alcoholics Anonymous. Throughout the book, allusions are made to twelve-step programs as being critical to any recovery from drugs or alcohol. This is most often done through excerpted self-reports from addicts and their family members which comprise a good portion of the book. These personal and often moving revelations are, in fact, the book’s backbone, as they provide great emotional substance to the account of the experience of cocaine addiction for the individual and his or hei loved ones. What sets this book apart from the majority of recent writings within the broad self-help movement is the audience for which it is primarily written: the cocaine abuser UT& his or her family members. both see themselves more clearly

By reading this book, cocaine abusers may and experience some empathy for the

suffering they have inevitably put their loved ones through. Experiencing the pain of others in similar predicaments is, in fact, one of the most useful means of‘ breaking through the individual abuser’s denial in early recovery. Rarely able or willing to see himself or herself clearly at this time, he or she is able at least to

the suffering of others and identify with it. III this way, the central purpose of Cocaine .Solutions may be analogous to introductory twelve-step meetings. ‘I-he family member or loved one of the cocaine abuser may read this book for a similar purpose. There is much for them to identify with here. ‘I‘he many complex, often contradictory emotions and personal states which family members of the cocaine abuser experience, at times siirlultaneously, are vividly portrayed: love and hate, hope and despair, excitement anti terror. dependence and independence. Some relief for the family member may be obtained in register

recognizing that one is not alone in such emotional confusion. The substance abuser, consciously and unconsciously, becomes a master manipulator- of’others’ emotions in order to fulfill his or her drug quest while maintaining the support and love he or she so desperately needs. The cocaine abusers’ revelations in this

132

I’.

I’lYl\er

hook openly tloc-ument this and thus allow the audience of f’mlily ii~rrr~l~~-s ~.ho react ic to ret-0gniLe these m~nii~on patterns. A reassuring tilessage that one gets f’roni rcactiiig C:oc~cC~rSohtlior~.c is that help and treatment fi)r the cocaine ahuser ~inct tunily inay c.omldeirient each other. A trend has developed recently in both the treatment and self-help arenas to polarize

written taniilv

the

work

of

by Janine

the

de Peyer,

niemhers

addict

and

presents

of the cocaine

fiun~ily. ‘I‘he chapter on “‘l‘he Family,” usef’ul, and supportive ideas on how may best promote their owii ;IS wvll as the

clear,

abuser

abuser’s recovery. FI‘he danger of “switching dctictions” is enit~liasir.ect as fiiniil> nienibers of’ten do not uncterstanct how the atmse of‘onc drug (e.g., mcaine) can easily he replaced ty the abuse of another (e.g.. ;ilcohol). 111;I sepiaale \Gii, the dangers for the faiiiilv nienibeiof being o\,er-iii\~olvetl (;I “cfetec.ti\,e”) iii evei-)’ aspect of’ the active reasonable responses

addict’s lifr to the addict

211-e af’f”‘of”-iatel~, m-e outlined, while

~riipliasized. I-extioriary

(Z0ric.rrte. approaches

are also identified and shown to be unhelpful antI ultimately hmmf‘ul to all involved. A reassuring discussion of‘enalding and co-depentlencv is ott’ei~tt, one Ili;il is generally informed and intelligent. As my01ie f’aniil’iar with the field of’ addiction ktto\vs, over the past few years there has Ixxn ;I prolif’eratiorl of‘ \\orks on this topic. ‘I‘he author of‘ this chapter states regarding co-ttel~endtmcy: “this word has t~~onie widely exploited and alniost clich&t in the field of addiction” (p. 104). While the family’s or loved one’s role ii), L ~ritt reactioli to. the xldiction l~ro~ess is of‘critic-al importance to all par&s i~lvolvett, much of’the rt~t’nt \vol-k in this arca 11~s taken on ;I proselytizing or stignl;lti/illg IOII~. As ;I Imull, ;dl too often

addicts

justification

approaches

lo\;rci that

oiic’s tia\,e

the

f’clr Idaii~ed

ftdy

~nc~lher’s take on XI ax usalorv tone.

1’01.rhvii- eiiahliiig

I)elia\ior.

Llsilig

the

own denial IIILISL IK hrokcn down, awl1 in rhe extreme hlmling the loved one f’o~

mid ils lxq~t3u;ition. a( least in part. ;I mube of’ the xlttiction Most appropriately, varioms t’ornis of’ “helping” belia\~ior \\hicli, xi-w tc, reinforce the addictive process arc unttenco~~t. ‘l‘he c.lcarcat. iiio~t sigiiif‘icmi1 pi-oldetii nitti sue-Ii “liell~ing” is that it “pixHtWs I tir addict f~imii fxiiig the

being,

~~~~lsecluencx~ of his or hcl- own hcha\~ior”. A usef’ul chcxklist o1’suct~ Ixha\~iors is prcscnted (pp. t 02-103). ;tltlioirgti il is ;d)itr;td\ statctl dial three or more ;ittimi;lrive i~rspoiises lo these itrnis qualifirs one 24 mi eiial~lci~. Siliiitar (0 the two other checklists in this Iwok (Atttiicr Questionnaire, p. 4’7; .4tlolescerlt Qiiestioniiairc.

p. (il ). the diagnostic

would haye 111~1slxxn best omitted. ctelxvident hetiaviol- are discussed

cl-item-ioil of’“ttir~

01 tiioi~t’” is unIt’sted

and

Likewise, wide itnport;ltlt eletnm[s of. CO(e.g.. taking OII (00 iii~~c.h i-espoiisil~ility,

having loose Imundaries. protecting the aclcfict). the author OII ou;~sio~l slips into rcfcl-ring to this trait as an all-inclusive pel-sodity ttisol-tlri;. I’eoplv art’ spoktm xiid ho-ttef)eildeiic.!, itself. is tlesci-ilmt as ail of‘ siniplisticallv as “co-depeiittents” Such cti~~i.~~ctei.iz~itiotis ~rcn’c oilI!, lo o\~eipmel-atim “actctiction” ai;tt “illness.”

mid stigiuari/.e rhc actual t)eli;iviors rhat ttiec attciript lo ctc3cril)e. 011~ of. the liluitatioils of‘ C;omi~c, .Solrrtic~rr.\is that virtuallv alI i-rfri-eiices 10 treat nieiit and recoverer al-e f rmiid bvithiii t lie t wel\.e-step niodel. At 011~‘ poilit the

authors

stmii

to even

iniply~

chat

i-ec‘o\‘ei3

is soiriettiitig

cuclusivc

IO the

Helping

the self withour cocaine

t 33

twelve steps. (” ‘Recovering’ is a term used by addicts who are participating twelve-step program.“) While no one can deny that this form of self-help

in a has

evidenced tremendous wide-ranging success in helping people recover from drugs and alcohol, descriptions of other self-help approaches, particularly that would have complemented the work in an of the therapeutic community, if not a significant majority of cocaine important way. A good percentage, addicts

benefit

from

treatment approach of the many people have been enriching.

a highly

structured,

intensive,

and at times confi-ontational

set in a long-term residential facility. Testaments from some who have deeply profited from this self-help process would Very often, this form of habilitative treatment provides the

necessary basis for the recovering individual to move on anti utilize twelve-step meetings in a program of life-long recovery. Finally, it is noteworthy that the authors attempt to provide some factual information on cocaine use including its biochemical actions, phenomenological effects, methods of usage, addictive properties, and relapse potential. While certain statements are generally accurate and intended for a lay audience, anecdotal and unsubstantiated by the literature. For example, in the chapter on the authors inappropriately present as fact that “most relapse prevention, relapses occur because an addict has not stopped associating with people who use drugs” (pp. 72-73). While this is certainly an important issue, such personal opinions should not be presented without supportive references for lay or professional audiences alike. In sum, Cocaine Solutions is a useful, refreshing book within an important selfhelp tradition. Cocaine abusers and their families, in recovery or not, will find it most helpful. Likewise, professionals in the familiarize themselves with issues surrounding develop a greater appreciation for the power

field may read it to the abuse of cocaine of self-help.

further and to