Download ExEcutivE dirEctor - Freedom Institute

freedom institute
founded 1976
Fall 2009
Relationship: bridge to
successful recovery
Letter from our
Rachel Ravin, LCSW
Anita Ronis, LMSW , CASAC
When clients enter treatment—deciding that the
negative (although familiar) consequences of their
drinking and other drug use outweigh the benefits—
they take a leap of faith. In so doing, they express a
willingness to believe that things will be better if they
can find a new way to live. That’s a big “if.” In truth, we
all are quite attached to the way of living we know.
The idea of abandoning what is familiar and comforting to become some new version of ourselves is understandably daunting. Yet, in recovery, such change
is necessary. The most fundamental change required
lies in the realm of relationships.
I’d like to share a story that is sometimes heard in the rooms of
recovery and that touches me deeply.
While in active addiction, a person’s primary relationship has been with a substance. The price of this exclusivity is debilitating isolation. Recovery is a process
of learning to accept support from other people. For
the newly recovering client, past relationships have
undoubtedly been a source of pain; and yet, it is only
within relationships that true healing can take place.
Listed below are some behaviors conducive to treating this disease of isolation with its most effective
antidote: supportive relationship.
Accepting. Perhaps the most vital element of a healing relationship is acceptance. As Gestalt pioneer
(Continued on page 6)
Executive director
While walking down the
road, a man comes upon a
butterfly’s cocoon. The man
stands watching as the butterfly struggles to get free.
In the spirit of kindness and
compassion, the man begins
to cut open the cocoon,
hoping the butterfly will
effortlessly fly free. But the
man then notices that the
butterfly’s body is swollen and its wings are not fully developed.
It is the struggle to work its way out the cocoon that forces
necessary fluids into the wings so that the butterfly can fly. The
man does not realize that his well-intended actions have interrupted the natural process required to enable the butterfly’s
body and wings to become fully functional. He has tried to
help, but has ended up crippling the butterfly.
Sometimes we need to struggle so that we may gain strength.
No one knows this better than those in recovery from their
own alcoholism or addiction, or the family members who have
learned to stop rescuing and enabling a loved one. The most
basic tenet of helping someone who is alcoholic or addicted
(Continued on page 2)
table of contents
„„ Keys to Change in Early Recovery..........................................................1
„„ Letter from our Executive Director........................................................1
„„ The Progression of Alcoholism................................................................3
„„ 2009 Benefit Dinner....................................................................................4
„„ About Detox...................................................................................................7
in a mother’s words...
Anonymous
Our younger daughter had just graduated from the 8th
grade when we began to notice her withdrawal. We didn’t
understand what was happening until we found a letter she
left lying on the dining room table. In it she bragged to a
friend that she smoked marijuana with kids who hung out
in Central Park after school.
A generation ago we had smoked marijuana ourselves. But
we knew today’s drugs are stronger and we sensed that today’s kids are more emotionally vulnerable. We didn’t want
our daughter to deal with difficult feelings by taking such
serious risks.
There were plenty of difficult
feelings to deal with. Our
older daughter had recently
been diagnosed as bipolar,
after episodes of angry and
erratic behavior over several
years. We now know that our
younger daughter was often frightened for her physical
safety, and also that she received far less of our attention
than she would have had we not been so distracted by our
attempts to define her sister’s suffering and find appropriate treatment. The marijuana discovery made us realize we
needed to find help for our younger daughter too.
We found Freedom Institute through our Employee Assistance Program. It wasn’t easy to get our daughter to talk
about what might be driving her away from us and toward
the drug culture. After two sessions, she was furious with us
and swore she wouldn’t go back. But she did, because she
had already formed a strong connection to her counselor.
Over the months that followed, Freedom Institute helped
our daughter - and us - to a deeper understanding of ourselves and our relationships. Our daughter emerged from
the process with knowledge she needed to understand her
choices, emotional support she needed to feel confident
about herself during a troubling time, and coping skills she
needed to handle the challenges of adolescence.
Today, she uses no drugs or alcohol, and is doing well in all
aspects of her life. We are very grateful to Freedom Institute.
Make recovery part of your legacy.
A charitable bequest is the ultimate gift you can make to
Freedom Institute. Bequests provide the means to have
a bigger impact than you may be able to afford
in the present.
For assistance or further information, please
contact Rachel Russell at 212.838.0044, ext. 16 or at
[email protected].
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unsung hero
Freedom Institute
congratulates John Laud,
Marketing Director and
Counselor, for receiving
the “Unsung Hero” award
from Caron Foundation
for his dedication to
recovery. He is pictured
here with Joe Lauginiger,
Jr., Caron’s Executive Vice
President and Chief
Development Officer.
LETTER FROM DIRECTOR (Continued from page 1)
accept help is that he must not be shielded from negative
consequences, but must feel the pain and discomfort his
choices cause. The same holds true for the recovery process. Everyone involved needs to do his own work, and will
have his own difficulties to overcome.
When times are hard, it’s best to rely on what’s tried-andtrue, to go “back to the basics.” This issue of Topics goes
back to the basics of addiction and recovery. Freedom
Institute provides solid, responsive and effective treatment
services to individuals and families who seek recovery from
alcoholism and addiction. Programs and services grow with
the changing needs of our clientele, rather than according to the latest trends. We are clear and consistent and
focused on our mission.
In this issue, Barbara Bock describes the most basic truth
about alcoholism – that it is a progressive disease whose
patterns and effects may vary from person to person, but
whose course is relatively predictable. Michael Noth and
John Laud spell out the details about detox, which is the
most basic level of treatment and, for many, the first step
towards sobriety. And Rachel Ravin explains what may not
be so readily apparent: the most essential component of
any recovery is relationship.
Over the years, Freedom Institute has formed, fostered and
even saved countless relationships. Our many grateful clients and recovery success stories (you can read one on this
page) are proof that Freedom Institute is “tried-and-true.”
We are here for those who need us, and we are grateful to
those who support us.
Anita Ronis, LMSW, CASAC
Executive Director
the progression of alcoholism
Barbara Bock, LCSW
Alcoholism is a chronic disease that follows a predictable
and progressive course which can be fatal. The progression
to alcoholism often looks something like this: experimental
use leads to misuse, which leads to abuse, which culminates in dependence.
Experimental use, often
begun in teenage years, can
start as a response to peer
pressure and/or social anxiety.
It typically results in a slightly
euphoric feeling. The thinking
is “Hey, this is fun – I feel good
and can socialize with ease.”
There are few or no negative
consequences at this stage.
Over time, the person begins to think, “Since this drink
makes me feel good, maybe another one will make me feel
even better.”
In the second phase, that of misuse, a person is beginning
to form a relationship with alcohol, though not necessarily a conscious one. He/she has begun to believe in the
power of alcohol to alleviate stress and anxiety, and has
now become an active “social drinker.” The level of drinking increases. At this stage, consequences begin to show
up - hangovers, embarrassing situations. And the thinking
is something like, “Wow, I drank too much last night. Won’t do
that again for a while…but what a good time!”
Next comes abuse of alcohol where the negative costs of
drinking finally tip the balance sheet. The person begins to
drink more and more, and although he/she may feel embarrassed by his/her behavior and terribly ill the next day,
he/she begins to rationalize his/her drinking, “Oh, I forgot
to eat, that’s why I blacked out. Next time I drink that much,
I’ll have dinner first.” Drinking may cause the person to put
himself/herself in situations of physical danger and/or fail
to fulfill important obligations. DUI is an example of this.
Despite persistent interpersonal problems and negative
consequences due to drinking, the person in this stage is
already planning his/her next drinking escapade. That it will
happen is neither questioned nor met with concern. At this
stage, he/she could still control his/her drinking, but generally chooses not to.
The final stage is dependence. At this point, the person
is in denial and completely unaware that the disease has
progressed this far. Controlled drinking is no longer an
option. Intermittent periods of abstinence mean nothing,
as some alcoholics do not experience physical withdrawal
symptoms. Utmost in the alcoholic’s mind is obtaining his/
her next drink, and his/her thinking is distorted. “I don’t
New Faces
Taina Batista - Taina began at the
Freedom Institute in 2009. Taina brings
with her a wealth of experience specializing in payroll, human resources and
insurance. Taina has been involved with
administrative work for over 6 years. She
is extremely personable, a huge team
player, and excellent at detail-oriented work and multitasking. She hopes to return to school in the near future
to pursue her Bachelor’s degree in Business and Human
Resource Management.
Maria Mack - Maria joined the
Freedom Institute team as Project
Coordinator in the Summer of 2009.
She previously worked as a Project
Manager for Nickelodeon and Marketing Coordinator for Lonely Planet
Publications. Her transition into
the non-profit sector came after volunteering at Austin
Recovery in Austin, TX and Hazelden’s Outpatient Center
in New York.
Available Soon...
The Independent School Program’s Parent Handbook:
“Stay Connected: Helping Your Teen Navigate Tough Choices
Drugs, Sexuality, and So Much More…”
For more information, contact Marjorie Terry at 212.838.0044, ext. 37.
feel happy. I must need a drink.” Personality changes, mood
swings and bizarre behaviors may occur. The alcoholic does
things that he/she would never find acceptable if sober, like
lying and stealing. The alcoholic’s self-worth goes spiraling
downward and he/she compulsively seeks the euphoria
once felt from drinking. As his/her emotional distress
becomes chronic, he/she drinks more and more to escape
it, but instead moves closer and closer to utter despair.
Many complex factors determine why some social drinkers
progress to alcohol dependence while others do not. These
include individual brain chemistry, family history, environment and psychology. Science continues to explore how
these systems interact and hopes one day to find a way
to prevent this disease before it takes root. For now, the
good news is that although alcoholism is not curable, it is
treatable. With professional help, many alcoholics achieve
sobriety and lead happy and fulfilling lives.
Barbara Bock has a Masters Degree in Social Work from
Columbia University. She has specialized in chronic medical illness, including addiction, and its effect on families and
significant others for many years. Barbara joined Freedom
Institute in 2008 and is currently a family therapist in Freedom
Institute’s Family Program.
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The 2009 Mona Mansell Award Dinner
the Pierre — MaY 11, 2009
Karen and Peter Lawson-Johnston and Maureen Lee with guests
Mona Mansell Award Recipient Peter Steinglass
Bruce and Cynthia Zirinsky
Patrick and Jen Robinson and guests
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Devon Fredericks and Jessica Mansell Ambrose
Peter Boeschenstein and guests
Allie Hanley and guests
Alec Baldwin watching Brooke Shields’ video tribute to
Freedom Institute
Susan Kneip and Irene Shaw
“I learned to do things
differently and be the mom
I am today for my children .”
Brooke Shields
in her video tribute.
Patsy Preston, Robert Gardiner and Frank Mansell
Clarke and Beth Keough and guests.
Master of Ceremonies George Whipple
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UPCOMING EVENTS
It’s not too late to join us for a day of fun and friendly competition - all for a good cause.
Freedom Institute Golf Outing
October 1st at The Creek Club in Locust Valley, Long Island.
Contact Rachel Russell at 212.838.0044 or click on Golf Outing at www.freedominstitute.org
Keys to Change (Continued from page 1)
Arnold R. Beisser says, it is only by accepting a part of
ourselves that we can find the footing to change it. In
Freedom Institute’s Early Recovery Group, rather than silence the voice of the “inner addict,” we give it space and
a chance to be heard. That voice inevitably represents a
part of self that is striving to protect the client from pain.
With this realization, a client begins to understand and
accept that the inner addict’s behavior springs from positive intention, however misguided.
Listening and expressing. Once we acknowledge our
inner addict, we can begin to listen for another voice. I
frequently ask clients, “When you hear the addict voice, is
there a part of you that feels differently?” The judgment
of newly recovering people often has been questioned,
with good reason. They are asked to be open to suggestion and to give up doing things “their way.” But to function in the world, they must learn to trust themselves,
perhaps for the first time. Expressing feelings and listening to others in a supportive environment are therefore
central to recovery. Time and again, I have seen a healthy
part of clients awaken as they recognize wisdom spoken
by a peer, separate sound from self-defeating thoughts,
and feel their own internal wisdom emerge.
Cultivating discipline. Addiction is fueled by a desire to
avoid feelings and a belief that somehow feelings cannot be withstood. Ideally, healthy parents model feeling
management and discipline for their children. Without
that childhood experience, people may feel the need
to avoid feelings at all costs. In recovery, we learn that
feelings come and go. Being able to self-soothe—learning to tolerate feelings rather than needing to escape
them—can mean the difference between a tough day
and a catastrophic relapse.
Giving and receiving love. M. Scott Peck, M.D. defines
love as “the will to extend oneself for the purpose of nurturing one’s own or another’s spiritual growth.”
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The tasks of early recovery certainly require an extension of oneself. Going to an AA meeting for the first time,
participating in group therapy, sharing at a meeting, and
asking someone for sponsorship all require tremendous
effort, especially when one is accustomed to retreating
from others. Each of these acts of self-care allows one to
experience relationship in small doses.
Building a network. When challenging situations occur,
those in recovery do well to have a variety of sources
of support. Ideally, they turn to others who understand
their particular difficulties. Group members often find
it easiest to begin this work by calling one another and
then, perhaps, peers from AA. A crucial source of support
can come from a Higher Power, defined as anything outside the self that fosters a spiritual connection: a traditional concept of God, the idea of a benevolent universal
force, the power of nature, the power of the group. This
relationship above all others may fill an inner emptiness.
Recently, a frustrated client posed the question, “When
will I stop turning to a drink?” When does addictive
behavior cease? The answer lies in cultivating a habit of
turning toward relationships—with self, with peers in
recovery, with a sponsor, with a therapist, with a Higher
Power—for the comfort and support we humans need.
Rachel Ravin joined Freedom
Institute staff in December
2007. She facilitates groups
and does individual work with
adult clients. Rachel earned
her master’s of social work at
NYU. She is doing post-graduate work at the Gestalt Center
for Psychotherapy and Training and has attended professional development workshops in psychodrama.
about DETOX
Michael Noth, LCSW, CASAC and John Laud, CASAC
In Freedom Institute’s early years, “drying out” was often
used by celebrity press agents as a badge of honor. An
alcoholic who called a detox unit was told in no uncertain
terms “do not stop drinking.” The patient, while not understanding this logic, was usually all too happy to get medical
permission to continue drinking until admission to the hospital. He or she had no idea that sudden alcohol withdrawal
could be risky.
Today, we have a much better understanding of the disease of addiction and its seriousness. For someone with
progressed alcohol or benzodiazepine dependence, the old
advice not to stop “cold turkey” can still be good. Medically
managed, inpatient, detox treatment offers safety from potentially dangerous withdrawal symptoms, and assistance
tolerating the discomfort which could otherwise cause
an individual trying to stop on his/her own to resort to a
relapse.
Detox is the first step in overcoming a substance addiction,
is the most intense level of treatment, and is considered an
emergency service. Stays in detox vary according to type of
dependence, stage of progression of the illness, and sometimes health insurance policies.
Substance
Alcohol
Opiates/Narcotics
(ex: Codeine, Morphine, Heroin, Vicodin
Oxycodone, Oxycontin, Percocet)
Sedatives/Depressants
(ex: Benzodiazepines, Barbituates,
Ativan, Librium, Valium, Xanax, Amytal)
Typical Length
of Detox Stay
3-5 days
5-7 days
Up to 14 days
The medical staff of a detox unit may prescribe a variety of
medication to help the addicted patient safely withdraw
from an alcohol/drug dependence, again contingent on the
type and stage of progression of the dependence. While
this may seem ironic, medically supervised prescription
use can prevent brain seizures, help the patient remain
calm during early acute withdrawal, manage withdrawal
symptoms such as cramps, joint pain, nausea and tremors,
and even help with sleep. Examples of medications used in
detox from alcohol and benzodiazepines include Librium,
Ativan, Clonidine and Trazadone. For the opiate-dependent
patient, low, tapered doses of methadone are still standard.
A drug called Suboxone (buprenorphine) is particularly
suited for ambulatory (outpatient) detox because it has
what’s called a “ceiling effect” that provides safety from accidental overdose should the addicted person relapse with
the opiate of choice.
Upcoming Professional Open House:
October 23, 2009
Treating Chronic Pain in Recovery
During detox treatment it is not uncommon for co-existing
medical and psychiatric conditions to become apparent.
(For example, dental infections that were not noticed while
on opiates; anxiety disorders that were masked by alcohol
use.) This is yet another reason for detox to be medically
supervised, so that clinicians and doctors can make sure
appropriate treatment is either obtained or included in the
discharge plan.
Nutrition also plays a vital role in detox. Patients with
progressed alcohol/drug addiction are often run down and
lacking important nutrients. A regular and balanced diet,
along with prescribed vitamin/mineral/protein supplements, is part of the treatment plan, especially for patients
with severely depleted metabolisms.
Most patients rest for the first 12 to 24 hours of detox, and
then start a series of educational groups and individual
counseling sessions focused on referral services for the next
phase of treatment. Detox is a very fast and intense, primarily medical, level of treatment. It is designed to stabilize the
dependent person, identify relevant clinical and medical
issues, and then refer to the best course of treatment. It is
not intended to be a terminal point in the treatment arc,
but rather a starting point on the road to recovery.
Michael joined Freedom Institute as
a full-time staff member in 2007. He
came from Cornerstone of Medical
Arts Center Hospital where he was
Clinical Director. Over the past decade, Michael has worked in a variety
of treatment modalities. Michael is
a graduate of the Hunter School of
Social Work.
John has been a CASAC since 1980.
He had a long career at The Smithers
Treatment Center from 1979 to 2000,
where he was a counselor for 10 years
and Director of Marketing. John has
served as Secretary and Vice President
of the Employee Assistance Programs
of New York, serving the corporations
and city agencies. He has been with
Freedom Institute since 1981, where
he serves as a counselor and Marketing Director.
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Non-Profit Org.
U.S. Postage
PAID
New York, NY
Permit No.
3236
freedom institute
515 Madison Avenue
New York, NY 10022
www.freedominstitute.org
This issue of Topics was created with the help of Kathryn Hecht, designer and Rachel Russell, editor.
Special thanks to Sandy Kennedy and Anita Ronis.
Board of Directors
Clinical staff
Independent School Program
Henry Christensen III, Esq.
Chairman
Jessica Mansell Ambrose
President
Clarke R. Keough
Secretary
William Murray
Treasurer
Anita Perrone Ronis
Executive Director
Peter Boeschenstein
Karen Lawson-Johnston
John Loeffler
Frank L. Mansell
Connie Murray
Patrick M. Robinson
George Whipple III
Anita Ronis, Executive Director,
Therapist
Dr. Dan Mierlak, Medical Director
Dr. Michael Fayne, Clinical Supervisor
Barbara Bock, Family Therapist
Mary Bohnen,
Director of Client Services, Counselor
Fran Calafatello, Adult Counselor
Richard Cino, Adult Counselor
Mary Condon, Interventionist Consultant
Adrienne Glasser,
Adult and Adolescent Counselor
Sandy Kennedy,
Compliance Coordinator, Counselor
Maria Kratsios,
Adult and Adolescent Counselor
John Laud,
Marketing Director, Counselor
Mary McAllister,
Family Program Coordinator, Counselor
Connie Murray,
Interventionist Consultant
Michael Noth,
Clinical Program Director, Counselor
Rachel Ravin, Adult Counselor
Charlanne Zepf-Bauerlein,
Director of Adolescent and
School Programs
Suzanne Bonfiglio, Counselor
Lisa Abroms Herz,
Adolescent Clinical Supervisor
Tessa Kleeman,
Supervisor, Adult Counselor
Katherine Prudente, Counselor
Marjorie Terry, Coordinator
Advisory Council
Dan Mierlak, M.D.
Nancy I. Stahl
Judith Moran, Esq.
Trustees Emeriti
William C. Ford
Ann Thorne
Consultants
Margaret Klein
Sari Kutch
Defne Koraman
Mildred Pisciotta
Development Team
Rachel Russell,
Director of Development
Kathryn Hecht,
Communications Coordinator
Administrative Team
Tina Anderson, Billing Manager
Taina Batista, Client Services Coordinator
Jennifer Flores, Administrative Assistant
Maria Mack, Project Coordinator
Barbara Malandruccolo, Bookkeeper