Recently, I attended an Alcoholics Anonymous meeting, specifically a Step meeting, and we were on Step 3. After the step was read, a gentleman across the table raised his hand immediately and started speaking about his computer system being confiscated by a national security force, that everything he said was being monitored and this had been going on for years. As time progressed and the story gained momentum, several of us glanced at the chairperson, who did nothing. The “share” came to an end 20 minutes later. There was no reference to the 3rd step, no reference to AA, no reference to recovery and no mention of alcoholism. As I sat, quietly irritated, I asked myself a few questions.
Why oh why God, did I ever pray for patience? I smiled at that.
Will people come back after listening to this? Will I?
What is the appropriate response in that situation?
What does this have to do with recovery coaching?
The last question is what I’ll try to address. I’ve had this topic in my head for a long, long time. So I proceed with caution (and no small degree of courage). The topic of addiction recovery and mental health integration stirs up emotion and fortified opinions. I have witnessed and partaken in many robust discussions. I have listened for years to people with a variety of perspectives.
Yet it’s muddy water. Before I dive in, and in full disclosure, I’ll provide some background information. Bob Savage, CCAR founder, hired me in January of 1998. As CCAR’s second employee, I was woefully unaware of the addiction treatment system, never mind the mental health system. I had no prior contact with it. Bob had worked within the State of Connecticut addiction system for 30 years. Near the end of his tenure, substance abuse (as it was known at the time) merged with mental health. He vehemently opposed this action, to no avail. His passion remained long after it was a done deal. Some of that rubbed off on me as I walked by his side in the early years of CCAR’s recovery advocacy.
So, I recognize I have an inherent bias. I am in recovery from alcoholism and cocaine addiction. That’s how I identify myself. Then again, I was 20+ years in recovery when I discovered that I might have had “social anxiety” when I was a teenager. In fact, a sister mental health advocate lovingly provided me with that diagnosis, “in case I ever need one”.
Over the past two decades, I have identified some defining characteristics that distinguish and separate the two systems. I believe these factors make integration difficult, like trying to combine oil and water. My thoughts are purposefully concise, to leave room for you to ponder, room to wonder, room to noodle. The discussion…continues.
Here’s a thought to chew on… Many people believe that everyone who becomes addicted must have a mental illness; otherwise the person would not have become addicted. Some believe everyone (addicted or not) has a mental illness. For me, I don't believe everyone has a mental illness. I don't believe everyone who seeks treatment is “dually diagnosed”. I believe if you drink a depressant (alcohol) long enough, you might become depressed. Would that person be given a diagnosis of depression?
Let’s move to some observations. Here’s my 1st one. Recovery, as proposed by the two systems, has different and opposing outcomes. The addictions system’s primary goal is to move people out. In contrast, the mental health system keeps people in.
2nd The majority of people in long-term recovery from addiction have faith in a spiritual higher power. The addiction treatment system supports this notion. In mental health, the system often points to a medication (or psychiatrist/psychologist) as the higher power. Spirituality is rarely discussed.
3rd. Addiction recovery seeks to involve family as part of the solution. Mental health often refers to the family as part of the problem, even going so far as to isolate the person from the family.
4th Historically, mental health practitioners have not done well in treating people with a substance use disorder (a few best practices at the time - electroshock therapy, sterilization and frontal lobotomies). I encourage you to do some additional research here. Addiction treatment programs are not exempt from poor practices either.
5th and final observation. Many programs “integrated” in my time with CCAR. It was like watching oil and water try to combine. It was not pretty. And every time an addiction program merged with a mental health program, it became a mental health program. The spirit of recovery was discarded or at best, became an afterthought.
What does this have to do with recovery coaching?
Many advocates from both arenas have shared that they don’t think the two roles ought to be combined. Yet, I have heard from administrations (and certification bodies) that we could have one “peer” role to work with people recovering from addiction, mental illness and/or both.
My suggestion is to keep two distinct roles. Let oil be oil. And water be water.
In 2015, I finished a thruhike of the entire Appalachian Trail, a trek of 2,189.2 miles. It took 189 days and 6 pairs of boots. During all that time alone with my Creator, my purpose in life became more precisely defined. I am, simply, to coach recovery. Recovery saved me from an early demise and brought purpose to my tattered life. I have learned that I’m a coach to my very core. I am blessed to put the two together. I started work at the Connecticut Community for Addiction Recovery (CCAR) in 1999. I became the Executive Director of this recovery community organization in 2004. I have trained the CCAR Recovery Coach Academy© dozens of times and have a hand in modifying, improving and adapting various recovery coach curricula. I’m old enough now to start considering my legacy. This is a way for me to share things I have learned in my recovery, in my role as Executive Director and a trainer. I find that when I speak I present the same messages over and over. It’s time to write them down.
Phil “Right Click” Valentine
Recovery established 12.28.87