Sane : mental illness, addiction, and the twelve steps

138 Pages·2010·0.85 MB·English

by  Hornbacher

Sane
Mental Illness, Addiction, and the Twelve Steps
Marya Hornbacher
Hazelden Publishing
Center City, Minnesota
800-328-9000
hazelden.org/bookstore
© 2010 by Marya Hornbacher
All rights reserved. Published 2010
Printed in the United States of America Nor part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording,
scanning, or otherwise—without the express written permission of the publisher. Failure to comply with
these terms may expose you to legal action and damages for copyright infringement.
Library of Congress Cataloging-in-Publication Data
Hornbacher, Marya, 1974-Sane : mental illness, addiction, and the twelve steps / by Marya Hornbacher.
p. cm.
ISBN 978-1-59285-824-8
Ebook ISBN 978-1-59285-988-7
1. Alcoholism—Treatment. 2. Mental illness. 3. Alcoholics Anonymous. 4. Twelve-step programs I.
Title.
HV5278.H67 2010
616.8606—dc22
2010006789
Editor’s note
The names, details, and circumstances have been changed to protect the privacy of those mentioned in this
publication.
This publication is not intended as a substitute for the advice of health care professionals.
Alcoholics Anonymous and AA are registered trademarks of Alcoholics Anonymous World Services, Inc.
14 13 11 10 1 2 3 4 5 6
Cover design by Theresa Jaeger Gedig Interior design by David Spohn
Typesetting by BookMobile Design and Publishing Services
Contents
Foreword
Preface
Acknowledgments
Step One: Acceptance
Step Two: Sanity
Step Three: Surrender
Step Four: Honesty
Step Five: Humility
Step Six: Willingness
Step Seven: Transformation
Step Eight: Responsibility
Step Nine: Restitution
Step Ten: Commitment
Step Eleven: Power
Step Twelve: Service
Epilogue: What It’s Like Now
Appendix A: The Twelve Steps of Alcoholics Anonymous
Appendix B: Peer Support Group Resources
Foreword
There are many poignant yet practical sayings in Twelve Step recovery. When it
comes to choosing a sponsor, it is often advised to select a person who knows the
way, goes the way, and can show the way. Each of these three ingredients would
seem rather important in identifying a person to help with the daunting task of
recovery from a co-occurring mental health and substance use problem.
Marya Hornbacher knows the way, goes the way, and shows the way. Sane is an
excellent bridge to the remarkable and miraculous transformation that can take
place through the fellowship and wisdom of the Twelve Step program of
recovery. What Marya Hornbacher does in Sane is interpret these twelve
suggested Steps for people with co-occurring disorders, making them
understandable, while anticipating and addressing common concerns and
questions. She translates recovery terminology that on the surface may seem at
odds with having a mental health problem, and makes it accessible to anyone.
The evidence is in: peer recovery groups such as Alcoholics Anonymous and
Narcotics Anonymous really work. Yet research shows that people with mental
disorders—particularly severe ones such as bipolar disorder, schizophrenia,
PTSD, or severe depression or anxiety—don’t connect with AA or NA as
successfully as people with more moderate emotional problems do. And even
when they do connect, they’re not as successful in sustaining recovery over time.
There are probably many reasons for this. Some have to do with the nature of
these mental health problems, which can be characterized by symptoms of
avoidance, isolation, withdrawal, and negativity that can preempt action.
Moreover, not all Twelve Step recovery groups are open to people with severe
mental health issues. This is remarkable, if not paradoxical, given that groups
such as AA were originally formed to offer social support and solutions to
individuals who often felt ashamed and socially marginalized by their disease.
The goal was to create a group that was inclusive and accepting, not exclusive
and judgmental. Fortunately, most peer recovery support meetings retain the
ambiance of acceptance and tolerance. The primary purpose remains, in essence,
to try to get sober and help others in doing so.
Still, for the person with co-occurring disorders, the thought of going to a
recovery support group meeting can be terrifying. In fact, the idea provokes
anxiety for just about anyone, but in this case the prospect is so threatening that
it is often avoided at all costs. So, since most alcoholics and addicts also have a
mental health problem, how do any of them ever make it to a meeting, let alone
stick around long enough to get clean and sober and engage in sustained
recovery? We don’t know. It may be a matter of miracles, willingness,
desperation, social support, serendipity, timing, good luck, or simply the
exhaustion of all other options.
In this book, Marya Hornbacher finds the way through or around these perceived
barriers, debunking common mythologies about Twelve Step meetings. Reading
Sane is akin to having an AA or NA sponsor. This book serves as the
introduction, the guide, and the validation of personal experience. Sane offers
ways of managing the complexity, of making it all seem okay.
Mark P. McGovern, Ph.D.
Department of Psychiatry
Dartmouth Medical School
Preface
I REMEMBER THE FIRST TIME I READ the Twelve Steps at an Alcoholics Anonymous
meeting. I sat down with my cup of coffee, avoiding everyone’s eyes, and stared
at the Steps on a poster on the wall. I made it through Step One all right—didn’t
make a lot of sense to me, but I got the general idea—and then I came to Step
Two: Came to believe that a Power greater than ourselves could restore us to
sanity.
I tripped over the word sanity, nearly laughed out loud, and then nearly cried.
“Sanity” was not something I was particularly familiar with. I have a mental
illness, bipolar disorder, and that in itself had taken from me time and again the
sanity I desperately wanted. Compounded by years of the insanity of alcoholism
and addiction, I was, at that time, pretty well convinced that sanity was
something I could never hope for. I sat there as that AA meeting was called to
order, slumped in my chair, and wondered if I should just walk out. I thought
there was no way I could ever have what the people around me seemed to have:
laughter, companionship, stability—and sanity.
I was very wrong. The Twelve Steps have led me on a fascinating, often
difficult, but eventually rewarding and powerful journey to a place of ever-
increasing sanity and stability.
In this book I try to stay true to Twelve Step recovery basics while setting out
some suggestions and ideas for how they can be practiced by someone who deals
with mental illness. In many ways, we will work the Steps no differently than
anyone else—addiction is addiction. But the fact is, there are certain challenges
the Steps appear to pose on first glance that may make them seem intimidating,
or even impossible, for those of us with mental illness. They are by no means
impossible, and they don’t have to be intimidating. My goal is to honestly
address the real challenges that people with a mental illness face as they apply
the Steps in their Twelve Step support group and in all areas of their recovery.
Of course the Steps aren’t the only support that we need to maintain mental
wellness. They didn’t cure my mental illness, and they won’t. That’s not their
function, and in fact, we shouldn’t expect them to be a miracle cure for anything.
But practiced thoroughly, consistently, and in the sequence they were written,
they can light the way on what is sometimes a very confusing path to recovery
from addiction and to successful management of a mental health disorder. The
Twelve Steps, in conjunction with all the other essential supports to mental
health, are exactly what AA’s Big Book says they can be: they are “a program
for living.”
When I was still caught in active addiction and therefore unable to manage my
mental illness, basic living was a constant struggle. That’s why my work in a
Twelve Step program was so vital: I needed, first and foremost, to maintain my
sobriety, because without sobriety, I have no hope of managing my mental
illness. Mental illness is a genetic brain disorder, and the brain chemistry of
people who have it cannot tolerate further disturbance by addiction to chemicals
or compulsive behavior. Like many of you reading this, I had to learn that the
hard way. The insanity of addiction—and addiction is itself a mental disorder—
fuels other mental disorders like gasoline feeds a raging fire. Active addiction
simply isn’t an option for us, and we must do everything necessary to find
release from our obsession with addictive substances and behaviors. Working
the Steps is the best way I, and millions like me, have found to do that.
By awakening qualities such as acceptance, willingness, humility, and honesty,
the Twelve Steps offer a design for living that allows me not only to better
manage my mental illness but to regain my sense of values. Mental wellness and
sobriety have everything to do with making good choices and taking right action.
As we learn to do this by working the Steps and seeking others’ help in our peer
support group meetings, we truly do come to a place of sanity.
This book also tries to bridge the gap some of us have felt between our
understanding of mental illness and the inaccurate perceptions of it that we may
have encountered in Twelve Step groups. Not everyone in recovery has a firm
grasp of what mental illness is or how it needs to be treated. We may have run
into people who were unaware that mental illnesses are physical diseases of the
brain, or people who didn’t understand that psychiatric medication is often an
essential part of our treatment. People who don’t know these things may have
told us that our medication was the same as “using,” or told us that our mental
health concerns should be kept out of our Twelve Step meetings. This message
can be alienating and can turn a person off from Twelve Step programs. In this
book, I hope that readers will find that they are not alone with these experiences,
that there are millions of us dealing with both mental illness and addiction who