Alcoholics Anonymous
Members Login
Username 
 
Password 
    Remember Me  
Miracles In Progress 12 Step Recovery Forums -> Alcoholics Anonymous -> Alcoholics Anonymous -> When DO you want to get well?
Post Info TOPIC: When DO you want to get well?
AGO


MIP Old Timer

Status: Offline
Posts: 619
Date:
When DO you want to get well?
Permalink  
 

Working the Steps

I have been scolded a few times (by fellow AA's) because of the fact that I sometimes share at meetings about how the Steps are meant to be worked immediately and quickly. I've been told that this "theory" will "harm" newcomers (having only a few days, a few weeks, or a few months) who could not possibly be "ready" to do the work yet. Then I'm usually told that these newer members should just go to meetings for a while and eventually they'll "know" when they are ready to get into the Program (if they don't relapse first.)

I do not agree that we first get our life together and then turn to God. I believe that we turn to God and then, AND ONLY THEN, do we begin to get our life together. That's exactly what the Steps are all about, getting God into the deal.

In the early days of AA, when a new person showed up to their first meeting and asked about when they were going to get into working the Steps, established members usually asked them, "Well, when do you want to get better? If you want to get better now, we'll be working the Steps now. If you DON'T want to get better now, I guess you can put off the Steps, but by doing so you're probably going to drink." And so it was in 1974 when I got sober, the reply being "In your case, the sooner the better."

As a matter of fact, Bill Wilson got into the Steps within a couple of days, Dr. Bob got into the Steps after one day, and Bill Dotson (AA #3) also got into the Steps after a few days. But for me the bottom line is "What does the AA Program and the AA literature have to say about it?" The following is a list of time frames found in the Big Book. Page and paragraph numbers are from the new Fourth edition.

Page xxvi:4 - "Though we work out our solution on the spiritual as well as an altruistic plane, we favor hospitalization for the alcoholic who is very jittery or befogged. More often than not, it is imperative that a man's brain be cleared before he is approached, as he has then a better chance of understanding and accepting what we have to offer." (So it says we need to be detoxed off of alcohol first, which usually takes two or three days but in extreme cases takes five or six days, before getting into the work. See also page xxvii:7.)

Page xxvii:5 - "Many years ago one of the leading contributors to this book (Bill Wilson) came under our care in this hospital and while here he acquired some ideas which he put into practical application AT ONCE." (In about three days Bill was into working most of what later became the AA program. See also page 13.)

Page xxvii:7 - "Of course an alcoholic ought to be freed from his physical craving for liquor, and this often requires a definite hospital procedure, before psychological measures (like the Steps) can be of maximum benefit." (For psychological measures to benefit us we need to be applying them. So again, it's saying we need to be detoxed off of alcohol first, which usually takes two or three days but in extreme cases takes five or six days, before getting into the Steps. See also page xxvi:4.)

Pages 13 thru 15 - "At the hospital I (Bill Wilson) was separated from alcohol for the last time (Bill was admitted to Towns Hospital at 2:30pm on December 11, 1934. Bill was 39 years old.). Treatment seemed wise, for I showed signs of delirium tremens.

 

townsbwrecord.jpg
A Most Important Piece Of Paper

"There I humbly offered myself to God, as I then I understood Him, to do with me as He would. I placed myself UNRESERVEDLY under His care and direction. I admitted for the first time that of myself I was nothing; that without Him I was lost (Bill takes what later became Step Three. He reached the conclusions of Step One on page 8:1 and Step Two on 12:4). I RUTHLESSLY faced my sins (what later became Step Four) and became willing to have my new-found Friend (God) take them away, root and branch (what later became Steps Six and Seven). I have not had a drink since.

"My schoolmate (Ebby Thacher) visited me, and I FULLY acquainted him with my problems and deficiencies (what later became Step Five). We made a list of people I had hurt or toward whom I felt resentment. I expressed my entire willingness to approach these individuals, admitting my wrong (what later became Step Eight). NEVER was I to be critical of them. I was to right ALL such matters to the UTMOST of my ability (what later became Step Nine).

"I was to test my thinking by the new God-consciousness within. Common sense would thus become un-common sense (these two lines refer to what later became Step Ten). I was to sit quietly when in doubt, asking ONLY for direction and strength to meet my problems as He would have me. NEVER was I to pray for myself, except as my requests bore on my usefulness to others (what later became Step Eleven). Then only might I expect to receive. But that would be in great measure.

"My friend promised when these things were done I would enter upon a new relationship with my Creator; that I would have the elements of a way of living which answered ALL my problems (what later became the first two parts of Step Twelve). Belief in the power of God, plus enough willingness, honesty and humility to establish and maintain the new order of things, were the ESSENTIAL REQUIREMENTS.

"Simple, but not easy; a price HAD to be paid. It meant DESTRUCTION of self-centeredness. I MUST turn in ALL things to the Father of Light who presides over us all.

"These were revolutionary and drastic proposals, but the moment I FULLY accepted them, the effect was electric. There was a sense of victory, followed by such a peace and serenity as I had never known. There was utter confidence. I felt lifted up, as though the great clean wind of a mountain top blew through and through. God comes to most men gradually, but His impact on me was sudden and profound.

"For a moment I was alarmed, and called my friend, the doctor (Dr. Silkworth), to ask if I were still sane. He listened in wonder as I talked.

"Finally he shook his head saying, "Something has happened to you I don't understand. But you had better hang on to it. Anything is better than the way you were." The good doctor now sees many men who have such experiences. He knows that they are real.

"While I lay in the hospital the thought came that there were thousands of hopeless alcoholics who might be glad to have what had been so freely given me. Perhaps I could help some of them. They in turn might work with others.

"My friend had emphasized the ABSOLUTE NECESSITY of demonstrating these principles in ALL my affairs. Particularly was it IMPERATIVE to work with others as he had worked with me (what later became the last part of Step Twelve). Faith without works was dead, he said. And how appallingly true for the alcoholic! FOR IF AN ALCOHOLIC FAILED TO PERFECT AND ENLARGE HIS SPIRITUAL LIFE THROUGH WORK AND SELF-SACRIFICE FOR OTHERS, HE COULD NOT SURVIVE THE CERTAIN TRIALS AND LOW SPOTS AHEAD. If he did not work, he would SURELY drink again, and if he drank, he would surely die. Then faith would be dead indeed. With us it is just like that." (So two or three days after Bill is admitted into the hospital on December 11th, 1934 he has a spiritual experience AS THE RESULT of working almost all the Steps immediately and quickly in a few days. He THEN talks with his doctor about what happened to him on December 14th and is released from the hospital on the afternoon of December 18th).

Page 58:2 - "If you have decided you want what we have and are willing to go to any length to get it - THEN YOU ARE READY TO TAKE CERTAIN STEPS." (I'd like to suggest that they are talking about TWELVE CERTAIN STEPS and you'll soon see why. Some say that we stay within the first three Steps for a year when you are new, but please notice what it says next about Step Three on pages 63 and 64.)

Page 63:4 - "NEXT we launch out on a course of VIGOROUS action, the first step of which is a personal housecleaning, which many of us had never attempted. Though our decision (which is the Third Step decision) was a vital and crucial step, it could have LITTLE PERMANENT EFFECT unless AT ONCE followed by a STRENUOUS EFFORT to face, AND to be rid of, the things in ourselves which had been blocking us." (So it's saying that this Third Step decision will have LITTLE PERMANENT EFFECT unless we IMMEDIATELY follow it up with an INTENSELY ACTIVE EFFORT to work Steps Four through Nine, because where we face these things that block us from turning our will and our lives over to God is in Steps Four, Five, and Six; and where we get rid of what blocks us from turning our will and lives over is in Steps Seven, Eight, and Nine. So the way we turn our will and lives over to the care of God as we understand Him is by IMMEDIATELY and STRENUOUSLY working AT LEAST the six middle Steps.)

Page 74:2 - "Notwithstanding the GREAT NECESSITY for discussing ourselves with someone (doing a Fifth Step), it may be one is so situated that there is no suitable person available. If that is so, this step may be postponed, ONLY, however, if we hold ourselves in COMPLETE readiness to go through with it at the FIRST opportunity." (See also page 75:1.)

Page 75:1 - "When we decide who is to hear our story (our Fifth Step), WE WASTE NO TIME." (So after we write our Fourth Step inventories of resentments, fears, sex relations and harms done; it says we IMMEDIATELY share our Fifth Step.)

Page 75:3 - "Returning home we find a place where we can be quiet for AN HOUR, carefully reviewing what we have done." (It's saying that IMMEDIATELY following our Fifth Step, we spend ONE HOUR of undisturbed and uninterrupted quiet time, seeing if the foundation we have built with our first five Steps is done honestly and to the best of our ability. Then see page 76:1.)

Page 76:1 - "If we can answer to our satisfaction (the questions in the previous paragraph), we THEN look at Step Six. We have emphasized willingness as being indispensable. ARE WE NOW READY to let God remove from us ALL the things which we have admitted are objectionable (in our Fourth and Fifth Steps)? Can He NOW take them ALL every one? If we still cling to something we will not let go, we ask God to help us be willing." (So Six immediately follows the hour we took after Five. So Five and Six are both done on the same day.)

Page 76:2 - "WHEN READY (which answers one of the questions of Step Six), we say something like this: 'My Creator, I am NOW willing that you should have all of me, good and bad. I pray that you NOW remove from me every single defect of character which stands in the way of my usefulness to you and my fellows. Grant me strength, as I go out from here, to do your bidding. Amen.' We have then completed Step Seven." (In Step Six, we were asked if we were now ready. If we are, we then do Step Seven. If there are SOME defects we are NOT willing to go to God with, we pray for the willingness to ask God to help us with them, but go on to Step Seven with the defects we ARE willing to ask God to help us with. Either way, Step Five, Six, and Seven are all done on the same day. Steps Three and Seven are then a daily striving and prayer, practiced for the rest of our lives.)

Page 76:3 - "NOW we need more action, without which we find that "Faith without works is dead." Let's look at Steps Eight and Nine. We have a list of ALL persons we have harmed and to whom we are willing to make amends. We made it when we took inventory. We subjected ourselves to a drastic self-appraisal. NOW we go out to our fellows and repair the damage done in the past. We attempt to sweep away the debris which has accumulated out of our effort to live on self-will and run the show ourselves. If we haven't the will to do this, we ask until it comes. Remember it was agreed at the beginning we would go to any lengths for victory over alcohol." (NOW is mentioned twice in this paragraph, and even says, "NOW we go out". So Steps Five through Nine are ALL done within a day or two according to the directions in the Big Book. If there are a few amends we are NOT willing to make, we pray for the willingness but proceed with the amends we ARE willing to make.)

Page 84:2 - "We vigorously commenced this way of living (Steps Ten and Eleven) AS WE CLEANED UP THE PAST (Step Nine)." (So Ten and Eleven are begun as soon as we start making amends.)

Page 156:3 - "But life was not easy for the two friends (Bill Wilson and Dr. Bob). Plenty of difficulties presented themselves. Both saw that they MUST KEEP SPIRITUALLY ACTIVE. One day (June 26, 1935, 16 days after Dr. Bob had his last drink) they called up the head nurse of a local hospital. They explained their need and inquired if she had a first class alcoholic prospect.

"She replied, "Yes, we've got a corker (Bill Dotson, whose sober date is June 26, 1935). He's just beaten up a couple of nurses. Goes off his head completely when he's drinking. But he's a grand chap when he's sober, though he's been in here eight times in the last six months. Understand he was once a well-known lawyer in town, but just now we've got him strapped down tight."

"Here was a prospect all right but, by the description, none too promising. The use of SPIRITUAL principles in such case was not so well understood as it is now. But one of the friends said, "Put him in a private room. We'll be down."

"Two days later (June 28, 1935), a future fellow of Alcoholics Anonymous stared glassily at the strangers beside his bed. "Who are you fellows, and why this private room? I was always in a ward before."

"Said one of the visitors, "We're giving you a treatment for alcoholism."

"Hopelessness was written large on the man's face as he replied, "Oh, but that's no use. Nothing would fix me. I'm a goner. The last three times, I got drunk on the way home from here. I'm afraid to go out the door. I can't understand it." (Part of Bill D.'s First Step, and please notice the Twelfth Step work over the next few paragraphs. Bill was only sober about 7 months and Dr. Bob only 18 days.)

"For an hour, the two friends told him about their drinking experiences. Over and over, he would say: "That's me. That's me. I drink like that."

"The man in the bed was told of the acute poisoning from which he suffered, how it deteriorates the body of an alcoholic and warps his mind. There was much talk about the mental state preceding the first drink."

"Yes, that's me," said the sick man, "the very image. You fellows know your stuff all right, but I don't see what good it'll do. You fellows are somebody. I was once, but I'm a nobody now. From what you tell me, I know more than ever I can't stop (more of Bill D.'s First Step)." At this both the visitors burst into a laugh. Said the future Fellow Anonymous: "Damn little to laugh about that I can see."

"The two friends spoke of their SPIRITUAL experience and told him about the course of action they carried out."

"He interrupted: "I used to be strong for the church, BUT THAT WON'T FIX IT. I've prayed to God on hangover mornings and sworn that I'd never touch another drop but by nine o'clock I'd be boiled as an owl."

"Next day found the prospect more receptive. He had been thinking it over. "Maybe you're right," he said. "God ought to be able to do anything (Bill D.'s Second Step)." Then he added, "He sure didn't do much for me when I was trying to fight this booze racket alone."

"ON THE THIRD DAY the lawyer gave his life to the care and direction of his Creator (Bill D.'s Step Three), and said he was perfectly willing to do ANYTHING necessary (Steps Four through Twelve). His wife came, scarcely daring to be hopeful, though she thought she saw something different about her husband already. He had begun to have a spiritual experience."

 

billw12thstep.jpg
Bill W. 12 Stepping The Man On The Bed

"That afternoon he put on his clothes and walked from the hospital a free man. He entered a political campaign, making speeches, frequenting men's gathering places of all sorts, often staying up all night. He lost the race by only a narrow margin. But he had found God and in finding God had found himself."

"That was in June, 1935. He never drank again. He too, has become a respected and useful member of his community. He has helped other men recover, and is a power in the church from which he was long absent." (So Bill Dotson, or AA #3, got right into the Steps within a few days, as was the practice in early AA.)

Page 291:6 - "The day before I (Earl T.) was due to go back to Chicago, a Wednesday and Dr. Bob's day off, he had me down to the office and we spent THREE OR FOUR HOURS formally going through the Six Step program (which later became AA's Twelve Step program) as it was at that time. The six steps were:

  1. Complete deflation (which later became Step 1).
  2. Dependence and guidance from a Higher Power (which later became Steps 2,3,6,7 & 11).
  3. Moral inventory (which later became Steps 4 & 10).
  4. Confession (which later became Step 5).
  5. Restitution (which later became Steps 8 & 9).
  6. Continued work with other alcoholics (which later became Step 12).

"Dr. Bob led me through ALL of these steps. At the moral inventory (Steps 4 & 5), he brought up some of my bad personality traits or character defects, such as selfishness, conceit, jealousy, carelessness, intolerance, ill-temper, sarcasm and resentments. We went over these at great length and then he finally asked me if I wanted these defects of character removed (Step 6). When I said yes, we both knelt at his desk and prayed, each of us asking to have these defects taken away (Step 7).

"This picture is still vivid. If I live to be a hundred, it will always stand out in my mind. It was very impressive and I wish that every A.A. could have the benefit of this type of sponsorship today. Dr. Bob ALWAYS emphasized the religious angle VERY STRONGLY, and I think it helped. I know it helped me. Dr. Bob then led me through the restitution step, in which I made a list of ALL of the persons I had harmed (Step 8), and worked out ways and means of slowly making restitution (Step 9)." (So again, most of the Steps being worked in one day.)

The 6 steps as Bill W. wrote them..

six_steps.gif
  1. Admitted hopeless
  2. Got honest with self
  3. Got honest with another
  4. Made amends
  5. Helped others without demand
  6. Prayed to God as you understand Him

And there you have it, so it was for me .. the spiritual experience happening on my 52nd day, April 21, 1974 .. I have not had a drink since my first meeting February 28, 1974, 13208 days ago today April 28, 2010, because of this kind of sponsorship by Tex R., Chuck C., Cliff W., Joe Q., Wino Bob and the rest who took me under their wing and made damn sure I understood that I was to work the steps immediately, if not sooner, Tex insisting that I learn my A.A. from the original 1938 manuscript for the BigBook!! And for that I am everlastingly grateful!!

I suggest you read the shortest paragraph in the BigBook on page 88:1

"It works - It really does"
adove.gif
Love and Peace, Barefoot

http://www.barefootsworld.net/aaworkingthesteps.html


-- Edited by AGO on Wednesday 28th of April 2010 07:33:30 PM

__________________
Build a man a fire and he will be warm for a night, light a man on fire and he will be warm for the rest of his life
Larry_H


MIP Old Timer

Status: Offline
Posts: 1008
Date:
Permalink  
 

Andrew

Again our thoughts align, this is getting scary (LOL)

I too think that far to many AA newcomers are given poor advice when told take the steps slowly.  I have even heard necomers advised take years it's OK.

Then I observe the famous AA waltz 1, 2, 3 Slip  1, 2, 3, Slip.  If their sponsor would have guided them on a steady pace through the steps a different outcome may have
happened.

Each person advances at a different rate through the steps, but as a sponsor my sponsee's don't sit still. Either they continue working or they can find another sponsor.  I found out a long time ago that I could not want sobriety for them more than they wanted it for them selves.

When I take on a new sponsee I ask "are you willing to go to any lengths?  Are you 
willing to follow all suggestions whether they make sense to you or not.  If they say yes, I will then sponsor them.  Sometimes I have to remind a sponsee that they said they were willing to go to any lengths.

This is a terminal illness which means you die with it and far too many die from it.
If your friend had cancer, you would not  advise them to go slow with the treatment,
let's not rush into this.  It's Ok to take years to treat your cancer.  But we think nothing of giving this advice to an alcoholic.

OK, OK I will get down off my soap box now.

Just pisses me off when I see people dying needlessly from Alcoholism because of bad advice.

Larry,
-----------------------
You don't have a problem. You have a solution you don't like

 

__________________
Mike B.


MIP Old Timer

Status: Offline
Posts: 2520
Date:
Permalink  
 

Great subject.
Yes, I would agree.  From what I've learned and experienced starting the steps early was critical for me.  I started through the steps after 3 years of re-lapsing.  Could stay sober on my own.  Go figure. 
Once in the steps I drank after completing step 4.  Woarse drunk yet.  Blacked out for 12 hours, Hospital visit and woke up in jail.  Worked on step 5 with my sponsor the same day I was released from jail.  Haven't picked up a drink since One Day At A Time.  I'm an advocate of starting and completing the steps throughly but quickly.  For some of us, we don't have time to wait. 

__________________
pinkchip


MIP Old Timer

Status: Offline
Posts: 3809
Date:
Permalink  
 

Having seen people with wet brain trying to work step 4, 5, 6, and 7, I would say they can be done too fast. I would only state that this is the case because the person has not done steps 1, 2, and 3 the right way so therefore, they don't need to be progressing on to other steps. That 1, 2, 3, waltz only happens when you don't do the first 3 steps the correct way. They are the foundation and the most important of the 12 steps in my opinion.

With that said, I don't see that progressing through the steps fast would hurt someone...they just need to know that they will need to go back and add to them once their brain clears up. It wouldn't have worked for me....and I would have been turned off by someone chiding me that I wasn't working fast enough when it was all I could do to go to meetings and not drink for a good period of time.

Furthermore, getting into arguments and getting heated about how, why, and when AA works for some is so utterly pointless and it is dry drunk behavior. All that matters is that it does Work.

Mark

__________________
Keep coming back. It works if you work it. So work it. You're worth it!
Larry_H


MIP Old Timer

Status: Offline
Posts: 1008
Date:
Permalink  
 

pinkchip wrote:

Having seen people with wet brain trying to work step 4, 5, 6, and 7, I would say they can be done too fast. I would only state that this is the case because the person has not done steps 1, 2, and 3 the right way so therefore, they don't need to be progressing on to other steps. That 1, 2, 3, waltz only happens when you don't do the first 3 steps the correct way. They are the foundation and the most important of the 12 steps in my opinion.


In case any newcomers are wondering what a wet brain is:

Wet Brain Alcoholism and Wernicke-Korsakoff Syndrome

Wet Brain

An ultimate and tragic consequence of years of alcoholic drinking, wet brain (Wernicke-Korsakoff syndrome) occurs from a thiamine deficiency due to malnutrition. In early stages, the syndrome can be partially reversed through treatment with large doses of thiamine; in late stage cases, there is no effective treatment.

Alcoholics become deficient in thiamine (vitamin b-1) through poor eating habits (liquid meals), damaged gastro intestinal systems that do not absorb nutrients well, and through liver damage (leading to a reduction in thiamine processing). Thiamine is an essential nutrient for glucose conversion in the brain, and over time, a thiamine deficiency leads to significant brain cell death and serious structural damage in certain areas of the brain. Areas of the brain most affected include the brain stem, the cerebral cortex and the pons.

Symptoms of Wet Brain

  • Ataxia, an irregular gait wide stance and short step
  • Confusion, which often manifests as apathy to external surroundings and low voluntary verbal participation
  • Confabulation telling of events that did not happen, and believing them to be true
  • Dementia
  • Hallucination visual, aural or tactile
  • Loss of control over eye movements

Treatment for Wet Brain

Patients suffering early stages of wet brain may respond well to large doses of intravenous thiamine, and may see a substantial symptoms improvement. Late stage patients will not benefit from any known treatment.

The mortality rate for wet brain is about 20%. Prompt treatment will lead to a full mental recovery for about 20%, a recovery from ataxia for about 40% and a recovery from irregular eye movement for about 60%.

Most patients suffering from wet brain have abused alcohol heavily for many years. The rate of occurrence in the general population is not known, but it is higher amongst certain subsets, such as the homeless and the elderly.

Anyone concerned about symptoms indicative of wet brain needs immediate medical attention.

Long years of heavy drinking may lead to a thiamine deficiency, and a syndrome known as Wernicke-Korsakoff (wet brain). Much of the brain damage experienced is unfortunately irreversible.

 



__________________
pinkchip


MIP Old Timer

Status: Offline
Posts: 3809
Date:
Permalink  
 

Full blown Korsakoff's syndrome is pretty rare...I felt I was in a strong state of mental confusion for a few months though...I call it "wet brain" cuz it felt like that even though it's technically not an appropriate use of the term. In reality for me it was just massive changes happening all at once, depression, relationship ending, alcohol cravings...etc.... It was not Korsakoff's. I was one of those alcoholics that pigged out when drinking too (hence there was not vitamin deficiency). I actually have gone from 240 to 185 since I stopping drinking - the reverse of what happens to most people I hear. I have lost more weight since stopping smoking too since now I can breathe easier and exercise.

__________________
Keep coming back. It works if you work it. So work it. You're worth it!
AGO


MIP Old Timer

Status: Offline
Posts: 619
Date:
Permalink  
 

pinkchip wrote:

Full blown Korsakoff's syndrome is pretty rare...I felt I was in a strong state of mental confusion for a few months though...I call it "wet brain" cuz it felt like that even though it's technically not an appropriate use of the term. In reality for me it was just massive changes happening all at once, depression, relationship ending, alcohol cravings...etc.... It was not Korsakoff's. I was one of those alcoholics that pigged out when drinking too (hence there was not vitamin deficiency). I actually have gone from 240 to 185 since I stopping drinking - the reverse of what happens to most people I hear. I have lost more weight since stopping smoking too since now I can breathe easier and exercise.



This isn't in The Big Book /evil grin LoL

but I think it is very common for us, could these have been what you were describing Pink?

 

Post Acute Withdrawl (PAW)

Exerpted From "Staying Sober" By: Terence T. Gorski

with additions by: Lee Jamison

When most people think about alcoholism or drug addiction they think only of the alcohol/drug-based symptoms and forget about the sobriety-based symptoms. Yet it is the sobriety-based symptoms, especially post acute withdrawal, that make sobriety so difficult. The presence of brain dysfunction has been documented in 75-95% of the recovering alcoholics/addicts tested. Recent research indicates that the symptoms of post-acute withdrawal associated with alcohol/drug-related damage to the brain may contribute to many cases of relapse.

Post-acute withdrawal means symptoms that occur after acute withdrawal. Post means after. And syndrome means a group of symptoms.

Syndrome: A group of symptoms

Post: After

Post Acute Withdrawal: Symptoms that occur after acute withdrawal.

Post-acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal.

Post-acute withdrawal is a bio-psycho-social syndrome. It results from the combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.

Recovery causes a great deal of stress. Many chemically dependent people never learn to manage stress without alcohol and drug use. The stress aggravates the brain dysfunction and makes the symptoms worse. The severity of PAW depends upon two things: the severity of the brain dysfunction caused by the addiction and the amount of psychosocial stress experienced in recovery.

The symptoms of PAW typically grow to peak intensity over three to six months after abstinence begins. The damage is usually reversible, meaning the major symptoms go away in time if proper treatment is received. So there is no need to fear. With proper treatment and effective sober living, it is possible to learn to live normally in spite of the impairments. But the adjustment does not occur rapidly. Recovery from the nervous system damage usually required from six to 24 months with the assistance of a healthy recovery program. Recent research is showing that for some recovering people the symptoms of PAW often occur at regular "moon cycle" intervals and without apparent outside stressors. Often those 30, 60, 90, 120, 180, and 1 & 2-year sobriety dates seem to be "triggering" times for PAW symptoms to increase. People recovering from long term opiate and stimulant use often have PAW symptoms for no apparent reason for up to 10 years after they have stopped using their drug of choice. Often PAW symptoms appear to come and go without apparent reason and without any specific pattern. Individuals who intend to have consistent long-term recovery must learn to recognize these symptoms and learn how to manage them.

SYMPTOMS OF POST ACUTE WITHDRAWAL

How do you know if you have PAW? The most identifiable characteristic is the inability to solve usually simple problems. There are six major types of PAW symptoms that contribute to this They are the inability to think clearly, memory problems, emotional overreactions and numbness, sleep disturbances, physical coordination problems, and general problems in managing stress. The inability to solve usually simple problems because of any or all of these symptoms leads to diminished self-esteem. A person often feels incompetent, embarrassed, and not okay about themselves. Diminished self-esteem and the fear of failure interfere with productive and challenging living. Lets take a look at some of the PAW symptoms that contribute to the inability to solve usually simple problems.

TYPES OF PAW SYMPTOMS

1.Inability to think clearly

2.Memory problems

3.Emotional overreactions or numbness

4.Sleep disturbances

5.Physical coordination problems

6.Stress sensitivity

Inability to Think Clearly

There are several thought disorders experienced by a recovering person when PAW is activated. Intelligence is not affected. It is as if the brain is malfunctioning sometimes. Sometimes it works all right. Sometimes is does not.

One of the most common symptoms is the inability to concentrate for more than a few minutes. Impairment of abstract reasoning is another common symptom of post acute withdrawal. An abstraction is a nonconcrete idea or concept, something that you cannot hold in your hand, take a picture of, or put in a box. Concentration is more of a problem when abstract concepts are involved.

Another common symptom is rigid and repetitive thinking. The same thoughts may go around and around in your head and you are unable to break through this circular thinking in order to put thoughts together in an orderly way.

Memory Problems

Short-term memory problems are very common in the recovering person. You may hear something and understand it, but within 20 minutes you forget it. Someone will give an instruction and you know exactly what to do. But you may walk away, and that memory becomes clouded or may disappear completely.

Sometimes during stressful periods it may also be difficult to remember significant events from the past. These memories are not gone; the person may be able to remember them easily at other times. The person realizes that he or she knows but just cannot recall it while experiencing the stress.

For an alcoholic named Jan this created a problem in AA. I have trouble presenting my story at AA, she said. I have trouble remembering events that happened before my drinking days, let alone things that happened while I was drinking. So to put my life in story form is hard for me. I dont remember all of my story. I do remember that some things occurred, but I get confused about when they happened. Many times I can remember things when I am alone with no pressure that I cant remember under the stress I feel when I talk at meetings.

Because of memory problems in recovery, it may be difficult to learn new skills and information. You learn skills by acquiring knowledge and building upon what you have already learned. Memory problems make it difficult to build upon what you have already learned.

Emotional Overreaction or Numbness

Persons with emotional problems in sobriety tend to overreact. When things happen that require two units of emotional reaction, they react with ten. It is like holding the times key down on a calculator. You may find yourself becoming angry over what may later seem a trivial matter. You may feel more anxious or excited than you have reason to be. When this overreaction puts more stress on the nervous systems than it can handle, there is an emotional shutdown. If this happens to you, you become emotionally numb, unable to feel anything. And even when you know you should feel something, you do not. You may swing from one mood to another without knowing why.

Sleep Problems

Most recovering people experience sleep problems. Some of them are temporary; some are lifelong. The most common in early recovery is unusual or disturbing dreams. These dreams may interfere with your ability to get the sleep you need. But they become less frequent and less severe as the length of abstinence increases.

Mike was a periodic drinker. Periods of sobriety usually lasted for several months. During the time he was not drinking, he had dreams that severely disrupted his sleep. His wife said, I never realized the nightmares Mike was having had anything to do with drinking or not drinking. He would frequently jump out of bed, screaming in terror. When I was able to awaken him and calm him, he couldnt remember what he dreamed, but he remembered being afraid. After a year of sobriety, he seldom had the dreams. Only then did I realize that they were related to his drinking.

Even if you do not experience unusual dreams, you may have difficulty falling asleep or staying asleep. You may experience changes in your sleep patterns; sleeping for long periods at a time or sleeping at different times of the day. Some of these patterns may never return to normal, but most people are able to adjust to them without severe difficulty.

Physical Coordination Problems

A very serious PAW problem though perhaps not as common as the others is difficulty with physical coordination. Common symptoms are dizziness, trouble with balance, problems with coordination between hand and eye, and slow reflexes. These result in clumsiness and accident proneness. This is how the term dry drunk came into being. When alcoholics appeared drunk because of stumbling and clumsiness, but had not been drinking, they were said to be dry drunk. They had the appearance of being intoxicated without drinking.

Stress Sensitivity

Difficulty in managing stress is the most confusing and aggravating part of post acute withdrawal. Recovering people are often unable to distinguish between low-stress situations and high-stress situations. They may not recognize low levels of stress, and then overreact when they become aware of the stress they are experiencing. They may feel stressful in situations that ordinarily would not bother them, and in addition, when they react they overreact. They may do things that are completely inappropriate for the situation. So much so that later on they may wonder why they reacted so strongly.

To complicate things further, all of the other symptoms of post acute withdrawal become worse during times of high stress. There is a direct relationship between elevated stress and the severity of PAW. Each intensifies the other. The intensity of PAW creates stress, and stress aggravates PAW and makes it more severe. At times of low stress, the symptoms get better and may even go away. When you are well rested and relaxed, eating properly, and getting along well with people, you will probably appear to be fine. Your thoughts will be clear, your emotions appropriate, and your memory all right. At times of high stress, however, your brain may suddenly shut down. You may begin experiencing thinking problems, inappropriate emotions, and memory problems.

If your thoughts become confused and chaotic or you are unable to concentrate, if you have trouble remembering or solving problems, you may feel you are going crazy. You are not. These symptoms are a normal part of your recovery and are reversible with abstinence and a recovery program. If you do not understand this you may develop shame and guilt which leads to diminished self-esteem and isolation which creates stress and increased PAW. It is a painful cycle that is unnecessary if you understand what is happening. As your body and your mind begin to heal and as you learn ways to reduce the risk of post acute withdrawal symptoms, productive and meaningful living is possible in spite of the very real possibility of recurring symptoms.

Recovery from the damage caused by the addiction requires abstinence. The damage itself interferes with the ability to abstain. This is the paradox of recovery. Use of alcohol or other drugs can temporarily reverse the symptoms of the damage. If alcoholics drink, or drug addicts use, they will think clearly for a little while, be able to have normal feelings and emotions for a little while, feel healthy for a little while. Unfortunately, the disease will eventually trigger a loss of control that will again destroy these functions.

For this reason it is necessary to do everything possible to reduce the symptoms of PAW. It is necessary to understand PAW and to recognize that you are not incompetent and you are not going crazy. Because post acute withdrawal symptoms are stress sensitive, you need to learn about PAW and methods of control when stress levels are low in order to be able to prevent the symptoms or to manage them when they occur.

Here are some stories about some people who experienced post acute withdrawal and how it affected their lives without their being aware of what was happening to them.

Ray is a young, single, recovering alcoholic. He stopped drinking when he was 22 and was very excited about the possibilities that lay ahead of him in his sobriety. After his initial treatment he began restructuring his life around recovery. He was eager to make up for the time he had wasted during his years of drinking. He got a full-time job, enrolled in college, and committed himself to doing some volunteer work.

After a while he began to notice that he was having trouble with his schoolwork. He found himself confused about things that had at one time been easy for him to follow and figure out. He was having trouble taking care of his financial responsibilities, and when people that cared about him tried to help him figure things out, he felt panicky and overwhelmed. Thoughts rushed through his head, and he was unable to put them in order. He says, When someone in the financial aid office at the college started talking to me about grant money, loan money, interest, and forms that needed to be filled out, I was so confused and overwhelmed that I couldnt hear what she was saying. Everything was going around in my head at once and I had to get away. I got up and left without filling out the financial aid form.

In desperation, and out of fear that he would drink, Ray ran. Instead of evaluating what things in his life he needed to change and what he needed to hold onto, he gave up everything. He quit his job, dropped out of school, and stopped doing volunteer work. He gave up his apartment and moved in with a relative until he could get himself together. These actions created additional problems with which he found it increasingly difficult to cope. Until he went to a counselor and learned some ways to manage his symptoms, Ray thought he was having a nervous breakdown, when in fact what he was experiencing was PAW.

Post Acute Withdrawl (Part #2)

__________________
Build a man a fire and he will be warm for a night, light a man on fire and he will be warm for the rest of his life
pinkchip


MIP Old Timer

Status: Offline
Posts: 3809
Date:
Permalink  
 

Yeah...PAWS..is probably accurate. Though it was also a grossly inaccurate and extraordinarily negative view of myself. I didn't need ego deflation right away in the form of awareness of defects. I saw myself as just one huge fuck up. I truly needed the people in AA to love me and support me some before I could see assets in myself. A 4th step from me in the beginning would have been just ripping myself over crap that probably wasn't even real. This is why I keep saying how important meetings are and in the timing of steps for me. I had to build a sense of self, then self esteem, and only then could I work past step 3 effectively...I needed time sober to get perspective...this is just me though.

__________________
Keep coming back. It works if you work it. So work it. You're worth it!
Page 1 of 1  sorted by
 
Quick Reply

Please log in to post quick replies.
Miracles In Progress 12 Step Recovery Forums -> Alcoholics Anonymous -> Alcoholics Anonymous -> When DO you want to get well?