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Ray Smith

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Ray Smith last won the day on November 5 2009

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About Ray Smith

  • Birthday 08/15/1954

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  • Location
    Asheville, NC
  • Occupation
    Mental health care worker

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  1. hi, just glimpsed at your introducing note on AA, thumbs up supportively

  2. What we do in ACT (Assertive Community Treatment) would be considered assertive case management. I was unfamiliar with CASSP, I did a little reading on it this morning. Could you expand on how has it changed and how the system reinforces destructive behavior?
  3. Excellent find. Couple of things: The Smart group engaged in more marijuana use, but the 12step group had more than twice the number of people on probation/parole. The consequences of usage were different and could account for the difference. "Twenty-one clients (39%) completed the 12-step program, whereas 29 clients (50%) completed the SMART program (difference not statistically significant)." I think 11% is significant, especially when more than 1/3 of the people in the 12step group were on probation/parole and dropping out could affect their legal status. In fact, the study does mention that the ones who stayed in treatment were more likely to be those with legal problems which begs the question, "How many would have stayed if their had been no legal reason for staying?" "A client-centered approach that was welcoming and nonjudgmental was stressed in both groups." Sorry, that is not typical 12step facilitation. In talking about SMART: "In general, revised cognitions increase a sense of empowerment and decrease a sense of victimization, so people feel more empowered in general, which can lead to specific as well as more generalized behavior change." Whereas, 12step promotes powerlessness over addiction and can lead to feelings of helplessness in many. Still, both SMART and 12step are only dealing with half the problem. The program I work for uses Motivational Interviewing, which statistically, offers the highest outcomes for the dually diagnosed over a two year period. We don't just deal with substance abuse or even substance abuse and mental health, but also housing, employment, education, and all the areas that affect quality of life. I believe the most important factor in in reducing harm is the client's belief that they are better off not abusing substances. It's one thing to tell a person, quite another to help the person experience it.
  4. Part of the problem I had as a teenager was the "Reefer Madness" approach to all drugs, which these days have been extended to alcohol. If society demonizes everything how is a person to understand the degrees of harm associated with different substances? After finding out that society lied about pot, why shouldn't I try other substances? My peers were saying that it's fine. The penalties for small amounts of one drug are hardly different from another. I grew up with "Better living through chemistry". There were a lot of mixed messages and a lot of hypocrisy during a very confusing time in my life. How are they supposed to know the difference between legitimate warnings and scare tactics when both are being used simultaneously? The root of this and many of our problems in my opinion is too many people. Think "the Rat Park experiment". "The disintegration of rational society started in the drift from hearth and family; the solution must be a drift back." - G. K. Chesterton, 1933. Unfortunately, we can't put that genie back in the bottle. Until such time that nature makes the decision for us, we'll be putting band-aids on our wounds as fast as we can.
  5. Allan, People are routinely pushed into AA for all sorts of offenses. Many of my dual diagnosis clients who were NOT alcoholics have ended up in AA where they started abusing alcohol and drugs like never before. Schizophrenics who drink three or four times a year when trying to lessen their symptoms or pass out that come to the attention of the police twice in a year get branded alcoholics and mandated to 12step treatment and meetings. Social Services seems to think that AA is a babysitting service, a place for people to get free group therapy. Some therapists and SS workers are two hatters who think everyone could benefit from the 12 steps. AA is the knee jerk reaction to a multitude of situations. People get worse when they receive treatment improper treatment and their real problems are ignored. "When all you have is a hammer, the whole world looks like a nail" doesn't work. We can't talk about alcohol and drug treatment without talking about 12step treatment because that is the starting place for most. How do you expect people to know what is good and what is not about AA? How are they supposed to know what to pick and choose in a program that dismisses "cafeteria-style AA"? You stated that you believe psychotherapy should be used in conjunction with treatment, but one in eight AA members speak out against the use of medications and therapy. Who is a person going to listen to anyway? The suit he sees once a month or his insta-friends that he sees several times a week who claim to know better?
  6. I can't talk about my recovery experience without talking about AA, some will call it bashing. Although I only attend sporadically for 19 years, I was walking around with AA thinking in my head. I was diagnosed with depression before I started drinking. I went broke trying to get professional help, antidepressants of the 70s didn't touch it, but I discovered amphetamines did. I started drinking in order to sleep. A few years later, I quit amphetamines, but continued drinking; it took just enough of an edge off of the depression that I wasn't suicidal. Folks in AA were always upset if I mentioned quitting amphetamines on my own. In 1982, the woman I was living with for 4 years gave me an ultimatum, quit dealing and quit drinking or she was leaving. I was drinking a couple of quarts a day. My eyes and skin suggested jaundice. I woke up after 4 hours of sleep with the DTs, I threw up until I could keep enough alcohol lessen the shakes. My doctor suggested a hospital detox. While in detox, the staff convinced me and my lady friend that I needed rehab afterward or I just just throwing away the money for detox. It was in rehab I first experienced AA. I am an atheist, in Avon Park I learned that AA was the only way to remain sober and in order to work the program of AA, I must find God. None of this stuff that your Higher Power could be a tree, GOD. I left after two weeks of verbal abuse and intimidation. I paid cash, no refund. I tried a few AA meetings, asking how an atheist could work the program. Same deal; I quit going. I went through a period of major depression. I stayed sober for nine months, but during that time a family friend who was big on AA told my mother and my lady friend that not attending AA meant I wasn't serious about my recovery. My mother severed all ties, tough love, and the lady left. I lost my natural supports and relapsed. I was convinced that if I got help for depression, I could stop. I had quit amphetamines cold turkey after taking them daily for 2 & ½ years. It was unpleasant, but I did it. Every mental health professional I saw said that in order to be treated, I must first attend AA and quit drinking for several months. Everyone dismissed the idea that atheists couldn't find help in AA. With doctors, therapists, friends, and family all claiming to know that atheists could find help there, I figured I must be wrong, the problem must be with me. When seemingly everybody tells you that you are wrong, you begin to believe them. I stopped listening to myself, I gave up on myself. People said I was crazy about AA and since I was already diagnosed with and suffering from depression, I questioned my sanity. So I'd go back, ask how an atheist could work the program and get abused again. I did stay around long enough to find out I had a disease that I was powerless over, always a good excuse to relapse. I decided that if the only way to stay sober was to become one of those people, I'd rather die. After seeing the way suicides were talked about in the rooms, I didn't want my death used as an AA cautionary tale: "He left AA and committed suicide." It would be ammunition for them and I didn't want to give them the pleasure. I figured drinking myself to death might take enough time for them to forget about me. Because I had been programmed to believe that I couldn't stay sober without them. I saw that the people in the rooms didn't care one bit about the people that passed through. They were either people who found God, recited dogma, stayed sober, swelled their ranks, and were beneficial to the AA story or they were outsiders that they claimed would die without them and they would claim these deaths proved that AA worked. Either way, it fits the AA dogma. In 2001, I went to Social Services trying to get help for depression. They told me I must agree to rehab, 6 months of alcohol/drug treatment and a halfway house, all 12step of course. No matter how I explained that if it weren't for the depression, I could quit on my own, that I had several times but the depression always drew me back, they wouldn't listen. I explained I had been though 4 rehabs already, that I am an atheist and the program would not work for me. I was told that they are professionals and know better than I did what I needed. I did get them to promise that I could get mental health help if I agreed. (I later discovered that there was a more appropriate dual diagnosis program within walking distance of the apartment I gave up.) Two months after rehab with no mental health help in sight, armed with my new Medicaid card, I walked into the local mental health center and demanded to be treated or locked up, that I was a danger to myself or others. "Especially others" was how I put it. It was a gamble that paid off. I got a sympathetic therapist who was able to talk me through most of my issues and supported me while system I was in tried to break me. He became a fierce advocate. After I was done with the treatment and halfway house, I moved into an apartment program. The apartment program manager and I butted heads; evidently, sobriety doesn't count if you're not doing it the 12step way. I took computer classes and got online where I discovered I wasn't the only one who had gone through this sort of thing and that there were other approaches. I kept looking around at the other methods looking for one that would fit just right. I never did, but it kept me busy and before I realized it, I had almost a year clean & sober. About this time, I developed an earache, the doctor prescribed Claritin. Claritin contains pseudophedrine, which showed up as amphetamines on my random drug tests. Despite my protests, I was tossed out on the street 5 days prior to one year of sobriety, my benefits canceled. As I sat in the park where I'd be sleeping that night, across the street from where I used to buy beer with $50 dollars in my pocket, I thought, "Nobody would blame me if..." and I stopped. I realized it wasn't about blame and excuses but about responsibility, my responsibility to myself. From that point one, is was easy. Social Services wasn't ready to let my supposed relapse go. (Turned out that my case worker and the apartment program manager who railroaded me were buddies.) They ordered more treatment which my therapist got changed to mental health treatment. They wanted me back in the same 12step halfway house for another 6 months. My therapist got that changed to a 30-day transitional home for the mentally ill. (Although I did get lost in the system and spend nearly 6 months there, my guess is purposely. During this time I lost my window for vocational education, something I was counting on.) I finally got an apartment of my own, but my Social Services case worker wasn't done making me jump through hoops. I found myself without benefits a couple of times for no reason, had to pay for my medications out of pocket, but I survived. Because I had been through the system, stayed sober and had my mental health in check, I was asked to help out with a dual diagnosis group at a local ACT program. All their clients were dually diagnosed, all had been through 12step treatment unsuccessfully. I was the only outspoken AA-critical, dually diagnosed person in town with more than a year of clean time. I volunteered there for over two years, during that time I received some valuable training, some of it under pioneers in the treatment of dual diagnosis. I went back to school on my dime for awhile. Once my life was in order, I tracked down an old flame that I had lost due to depression and alcoholism. We were married in 2005. I now have a life that I don't want to lose, I believe that's the real trick to me staying sober. A program based on the fear of "jails, institutions, and death" would be too anxiety provoking. AA taught me that I wasn't responsible, that I was powerless over my alcoholism. They tried to teach me that I couldn't possibly do it without them. They taught me to constantly second-guess myself, not to trust my feeling and emotions, to ignore the cognitive dissonance. They lied and robbed me of myself.
  7. Protecting a person before they get harmed in recovery world is exactly what I'm trying to do. When 95% of people drop out of AA in their first year (AA's numbers), that shows that something is wrong. I was a volunteer peer advocate with a program whose clientele were all dually diagnosed. They had all been through 12step treatment and AA/NA, most several times, all unsuccessfully. I now work in mental health primarily with those who have coexisting substance abuse issues. Together, over five years in the field. I've run DRA, SOS, and harm reduction groups, each has had their success stories and their failures. All of them have had people who feel they had been harmed by AA/NA. Besides the anti-medication factor and the 13th steppers which are obvious (and tolerated in the rooms), the philosophy of AA is damaging for many. The idea that addiction isn't the people's fault, that is a disease that they powerless over is seductive. People don't want to admit that their actions led to their addictions, that's the pull of 12step groups. Belief that they are powerless gives them an excuse for relapses. When people in AA relapse, it is practically scripted that they go out on a full class binge. The Brandsma study showed that binging occurred five times as much with people in 12step treatment as those who received no treatment and nines times more that those who had received rational behavioral therapy. AA is fear-based program, all the talk of "jails, institutions, and death" and the horror stories of how people who leave die are scare tactics not health coping skills. People, especially those with coexisting disorders, respond better to Motivational Interviewing/Motivational Enhancement than fear. And some, like myself, could not accept the religious nature of the program. I have had several clients with religious delusions that were all too eager to accept AA religiosity and incorporate it with their own that ended up badly. It's for these reasons I cannot, in good conscience, suggest AA as a treatment method.
  8. Saying there are no statistics, then saying that you don't want links to statistics is disingenuous. The largest study of its time was done by George Vaillant, Harvard professor and (former) member of AA's Board of Trustees. He compiled several earlier studies and ran his own. He had set out to prove that AA worked and found it worked no better than no treatment at all and had a higher mortality rate. If we don't talk about stats & studies, facts & figures, we're merely giving opinions. AA has been given some great press since it began mostly testimonials. While testimonials have their place, if they were always true, I'd be spending my time making thousands of dollars a month in two hours a day on the internet rather than spending my time posting in forums such as this.
  9. It's easy to claim that people lie, care to point out specifically which lies are being told about AA?
  10. A minority opinion, but a vocal one: "Only 17% believed an individual should not take it and only 12% would tell another member to stop taking it. Members attending relatively more meetings in the past 3 months had less favorable attitudes toward the medication. Almost a third (29%) reported personally experiencing some pressure to stop a medication (of any type)." Alcoholics Anonymous and the Use of Medications to Prevent Relapse: An Anonymous Survey of Member Attitudes; Rychtarik, Connors, Dermen, Stasiewicz; (J. Stud. Alcohol 61: 134-138, 2000) Interesting that the more meetings, the more likely to have this attitude. I believe progree was sarcastically repeating what he has heard in the rooms. I heard something similar last night at a NAMI meeting from a former AA member who believes if he found the right prayer, he wouldn't need his psych meds.
  11. Someone on the VH1 boards told me that Alcoholics Anonymous was compatible with Catholicism, I beg to differ: "Wow ray I really can't believe your take on the god thing. You have it all wrong. We in AAA don't believe in a different god. I was brought catholic so it was not abig thing for me. I don't believe the god they speak about is different from the one that was beat into me 45 years ago" The Catholic God healed the sick, made the lame walk, raised the dead, right? The god of AA can't cure alcoholism, only grant a daily reprieve. Pretty wimpy by comparison. When Bill Wilson said that you can choose whatever concept of a Higher Power you like, that's saying they are all equal and that is, as any good Catholic should know, is the sin of indifferentism. "Indifferentism is a mortal sin; a condemned heresy. That's the Catholic view of the matter." from "It's Catholicism, or Indifferentism": http://www.thinking-catholic-strategic-center.com/indifferentism.html Wilson allows the blending of different beliefs, the sin of syncretism. Syncretism is the fusion of different forms of practice or belief. from Devotions for Growing Christians: http://www.growingchristians.org/dfgc/edevo/syncretism.html The Seventh Step: "Humbly asked him to remove our shortcomings", humbly or not is a demand for a miracle, something the God of the Catholic Church frowns on. There is no evidence that Wilson embraced Jesus Christ, the only way to the Father in any Christian church, but he did embrace supernaturalism, holding séances, using Ouija boards, channeling spirits, all heresies. Do you think his "spook sessions" are compatible with Christianity? As one letter writer to Christianity Today wrote, "AA teaches belief in a generic god while prohibiting discussion of Jesus Christ. This is not a bridge to Christ but a bridge to Babylon. . . . Thank God I was shown a way out from AA’s teachings. Many remain lost." Chris Deile. "In His 12 Steps." Christianity Today, February 5, 2001, pp. 9-10. http://www.psychoheresy-aware.org/bobs11_1.html Wilson claims that all atheist and agnostics need to do is come up with their own version of God, however if they do this they are no longer atheists or agnostics. I'm relatively certain Wilson didn't have a firm grasp on what those terms meant; he called himself an atheist in his younger days, but also claimed he never lost faith in the Creator. "Stress the spiritual feature freely. If the man be agnostic or atheist, make it emphatic that he does not have to agree with your conception of God. He can choose any conception he likes, provided it makes sense to him. The main thing is that he be willing to believe in a Power greater than himself and that he live by spiritual principles." The Big Book, William G. Wilson, Chapter 7, Working With Others, page 93. He also claimed one could use the AA group as their Higher Power: "You can, if you wish, make A.A. itself your 'higher power.' Here's a very large group who have solved their alcohol problem. In this respect they are certainly a power greater than you, who have not even come close to a solution. Surely you can have faith in them. Even this minimum of faith will be enough. You will find many members who have crossed the threshold just this way. All of them will tell you that, once across, their faith broadened and deepened. Relieved of the alcohol obsession, their lives unaccountably transformed, they came to believe in a Higher Power, and most of them began to talk of God." Twelve Steps and Twelve Traditions, William G. Wilson, pages 27-28. Then here comes the bait & switch: "To certain newcomers and to those one-time agnostics who still cling to the AA group as their higher power, claims for the power of prayer may, despite all the logic and experience in proof of it, still be unconvincing or quite objectionable. Those of us who once felt this way can certainly understand and sympathize. We well remember how something deep inside us kept rebelling against the idea of bowing before any God. Many of us had strong logic, too, which 'proved' there was no God whatever. " (Twelve and Twelve, Step Eleven, pg. 96) (Note the use of past tense.) "So, practicing these Steps, we had a spiritual awakening about which finally there was no question. Looking at those who were only beginning and still doubted themselves, the rest of us were able to see the change setting in. From great numbers of such experiences, we could predict that the doubter who still claimed that he hadn't got the 'spiritual angle,' and who still considered his well-loved AA group the higher power, would presently love God and call Him by name." (Twelve and Twelve, Step Twelve, pg. 109) This is not taking Wilson's words out of context, it is bringing them and his deeds out in the open. Do you not read the literature or not notice the inconsistencies? People who believe AA is compatible with Christianity must not have examined either carefully.
  12. It is a valuable logic tool: a major premise, a minor premise, and a conclusion. It is only faulty if you use faulty input or semantic skulduggery. When Bill Wilson, talking about AA, states, "Our real purpose is to fit ourselves to be of maximum service to God and the people about us", I take that at face value. If this quote means other than what is states, then perhaps Wilson is too subtle or cryptic for my reading skills, something I doubt; Wilson was never known for his subtlety or his writing prowess. AA literature is full of references that refer to 'getting right with God' as being the core of AA; stopping drinking is seen as a byproduct of this new relationship with one's "Higher Power".
  13. At one point, I was drinking a couple of quarts or more a day. My eyes turned yellow, my skin took on a yellowish tint. My urine was very dark and my sweat was sickeningly sweet. Once I quit drinking, it took a few months before my Bilirubin levels came back to normal. I never approached that level of drinking again.
  14. Unless one believes in some sort of God or takes on some sort of "higher power", they should not expect any type of support in the rooms. After you've been around a bit, your "higher power" should conform to the God of everyone else in the room. As it was explained to me, "It says 'WE came to believe', not 'I decided'." I found nothing but pressure to start believing in God. I was called a liar, that I was only trying to draw attention to myself. I was told I wasn't being honest with myself by claiming I didn't believe. I wasn't being willing or teachable. I never received any support, the 'unconditional love' they talk about in the rooms is reserved for believers.
  15. What's the most important factor in overcoming alcoholism? Dear Stanton: Does the amount or extent of what there is to lose in one's life (successful career, loved ones, money, respect, etc.) have an impact on helping an alcoholic to recover? At the risk of overstating, if an alcoholic realizes how much is at stake personally and/or professionally, has this been shown to be a positive incentive for cessation of alcohol abuse? Thank you in advance for your guidance. Best regards, Jason Dear Jason: I couldn't put it better myself. To quote George Vaillant, in The Natural History of Alcoholism, refering particularly to Baekeland et al. (1975): The most important single prognostic variable associated with remission among alcoholics who attend alcohol clinics is having something to lose if they continue to abuse alcohol.... Patients cited changed life circumstances rather than clinic intervention as most important to their abstinence.... Improved working and housing conditions made a difference in 40 percent of good outcomes, intrapsychic change in 32 percent, improved marriage in 32 percent, and a single 3-hour session of advice and education about drinking... in 35 percent. These results apply in all situations-in other words, more than the type of therapy, or even whether the person enters therapy, the best chance for recovery is due to the number and quality of the person's attachments to life. Having people that care about them, including family, friends, and community involvements; having activities of every sort that they find meaningful; having work skills, opportunities, and involvement; and so on predict whether people will have the motivation and resources to overcome alcoholism. They have both more to lose and more to counteract the appeal of the addiction. References Baekeland, F., Lundwall, L., & Kissin, B. (1975). Methods for the treatment of chronic alcoholism: A critical appraisal. In R. J. Gibbons, Y. Israel, H. Kalant, R. E. Popham, W. Schmidt, & R. G. Smart (Eds.), Research advances in alcohol and drug problems (Vol. 2, pp. 247-327). New York: Wiley. Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge, MA:Harvard University Press. Best, Stanton http://www.peele.net/faq/factor.html
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