Michael Bower, Ed.D.
Working with young men who are addicts and alcoholics can be a challenging, frustrating and satisfying privilege. Throughout the storm of addiction and the chaos in their behavior, I hold on to some key ideas that I think characterize both illness and recovery. Most of us think of AA as a grass-roots organization that works well with alcoholics. But few see AA as grounded in psychology. I want to share some of the understanding I have found in bringing together psychological theory with AA practice. These ideas have been helpful to me and in turn to my clients. It is my hope that you will find them useful as well. In the 1950's, psychology and psychiatry continued their advancement by coming up with new ideas about mental health which centered on a holistic theory of personality. A holistic theory is one that understands how a system works without breaking the system into parts. The holistic theories believed that personality acted as a whole, indivisible system. Previously, it had been thought that when people had mental health problems, one part of the personality was askew but that the rest continued to work. The holistic theories thought that personality didn't work that way. It was an all or nothing proposition. When the personality system wasn't working, all of it, the entire system wasn't working. Personality acts like an operating system to a computer-if one part doesn't work, then the whole system doesn't work. And when one system is operating, no other system can work. Each system, healthy or not, works as a complete exclusive system. So personality systems are thought t o be "either/or" in t heir operation. This is an odd idea and doesn't at first seem to make sense. Perhaps the best way to understand this either/or phenomenon is to look at the drawing to the right. This classic visual gestalt shows either/or organization. When you look at the figure, you can see either the two faces in white or the vase in black. You can't see them both at the same time. It's odd but it is how the mind works. Holistic theory holds that personality worked in a similar fashion. So enough of theory. Why is this important? It helps to explain the world of addicts and what has to happen for recovery. Addicts don't have a localized part of their personality that is off-it's all of them. AA says "You are either moving away from a drink/drug or you are moving towards one". This either/or position of AA is not meant to simplify a complex disease but it recognizes that either the healthy/sober system or the ill/addict system is working. Or as veteran AA members are so fond of telling newcomers "You don't have to change much, just everything". Addicts' perception, thinking, their understanding of the world and their relationships are all part of the "addict system". For people who know and love addicts this is especially disconcerting. It is hard to believe that their once healthy personality is so completely gone. But it is like looking at the vase and wondering where the faces have gone. This is also why boundaries are so important, because when a person is in their unhealthy system, they are incapable of making healthy choices. And at that time, the expectation that they can make healthy choices is unrealistic. How does a young man become the person we knew he could be? Where is the lovable boy we knew? How does a young man get back to a healthy system? There are definite stages that one must go through to change. The first is a recognition that life is not going well. This may seem like too simple a step but for addicts/alcoholics it isn't. And for tenacious young men, it can be extremely difficult. I've heard numerous stories of how street life is a way for them to test themselves, a way to know if they are capable and competent. It sounds "crazy" but it makes sense in their system of thought. So the first part of changing is to accurately see that their life may not be working well. When those around an addict or alcoholic maintain clear boundaries, it's possible for the young man to see that his thinking and behavior may not be working well. When there is a crack in the system, the potential for change opens up. The second stage of change is the most difficult. This stage is characterized by the understanding that life could be different-just possibly there is another way. Most of us live in our own worlds; we believe our thoughts, we rely on our perceptions and we surround ourselves with people who see life as we see it. We reinforce what we believe to be true. To even imagine that life could be different than it currently is can be a tremendously courageous act. In order for the young men at Turnbridge to change, they must see that they can be different and that their lives can be different. This means changing core beliefs about themselves and the world. (Remember: "You don't have to change much, just everything".) Core beliefs are the principles of how one thinks about his self and the world. These beliefs are what keep the healthy or unhealthy system in place. Finding and correcting inaccurate beliefs is a complex and completely individual process. I can't understate how courageous it is to engage in this process. Walking into the unknown is terrifying. As core beliefs change, the old system falls apart (the start of stage 3) and a new healthy one can reorganize thinking and behavior. Turnbridge is extremely helpful with this process. Young men can reclaim activities that are important to them, and they reclaim them by using their healthy system. So a concert now becomes about the music rather than the drugs. New friends become a source of support and camaraderie rather than people who cosign self-defeating behavior. As a new healthy personality system takes over, everything changes. This is the time when loved ones can't quite believe the changes, the addict sounds too good to be true. There can be periods of flipping between systems and even backsliding into picking back up the old system but once someone has experienced a healthy personality system, they come to know the difference. Of course one theory never explains everything. And there are mental health issues that do not fit into this framework. But I think it can be helpful in understanding a view of how the personality works and why addicted young men appear so unreachable at times. It is also a theory of change and hope. Part of why working with young men at Turnbridge is so rewarding is that their healthy system has not been lost in decades of addiction. They really do want to get and to live better. ...................................................................................... Michael Bower, Ed.D. Dr. Bower has had a wide range of experience in counseling and education with 35 years of experience as a psychologist, high school principal, and university instructor. Most recently, he was Director of the Yale Psychiatric Educational Outreach Project which coordinates psychiatry residents teaching emotional literacy topics to middle school students. He also has a successful private practice located in Guilford, CT which focuses exclusively on the unique needs of adolescent males and young men. Mike is a National Certified Counselor (NCC) and Licensed Professional Counselor (LPC) and holds degrees from Tufts, Boston and Harvard Universities.