Mar 30

Equine-Assisted Therapy: Not Only For Addictions Facilities

As seen in 28 Days, a movie addressed a couple days ago on this blog, equine-assisted therapy can be used to help addicts in recovery. In addition, it also helps people with various other types of disorders, physical as well as mental.

One certified Equine-Assisted Psychotherapist, Camille Matthews, offers “5 Reasons Horses Make Good Psychotherapists“:

  1. Horses have the qualities clients want in a therapist. These include having authenticity, being open communicators, being perceptive and attuned, and being able to mirror others.
  2. Horses set ground rules for respect. “Horses have individual personalities like humans and horse herds and groupings operate according to complicated social relationships and interactions based on clear rules about power, physical boundaries and personal space.”
  3. Horses have problems too. For example, they experience “anger, jealousy, impatience and possessiveness. Most clients find it uncomfortable to acknowledge such problems directly, and being able to observe and reflect on the horse allows the client to identify and discuss these problems without defensiveness.”
  4. Horses deal in natural consequences. “If we don’t get it right, they don’t get it done.”
  5. Horses make therapy fun. They allow clients “to be playful, to think outside the box, let go of shame, blame and self-consciousness and get to work finding creative solutions.”

The following clip is from Sundance, an addictions recovery institute:

An article (in the addictions magazine Counselor) written by another certified Equine-Assisted Psychotherapist, Nancy Jarrell, is more personal. Here’s one of the things that makes equine-assisted therapy special to her:

I always tell my participants that they can’t do anything wrong in my sessions; how they show up with the horse is how they show up in the world…Sometimes simply asking a client to walk a horse will reveal that person’s pattern of behavior in relationships. If I see someone staring at the horse the entire time they walk him in a circle, I might ask who they feel the need to check up on. Their responses may be, ‘my mother, my husband, my son, etc.’ From there, I can invite them to practice new behavior — walking the horse again, eyes forward, head up; looking in the direction they are going. This provides intervention on dependency issues, and practice in letting go of control in relationships. The result is consistently a more relaxed walk with the horse, and a more effective mutual relationship. This can provide the client with insight into how attempts to control will result in more energy being expended with poor results.

Finally, in the words of mental health and addictions writer John Lee: “Equine assisted therapy leaves no room for intellectualization. You feel, you react – and you reveal. And just as it shows to a trained therapist the truth of your character, it can also help those in recovery to understand their true natures, and face more head-on some of the real obstacles to emotional growth and recovery.”

Mar 29

“Rachel Getting Married”: Rehab Interrupted, Emotional Chaos

The contemporary slice-of-life film Rachel Getting Married (2008), directed by Jonathan Demme, features Kym (Anne Hathaway), a young woman who’s tried substance abuse rehab a number of times and hasn’t yet succeeded. In fact, she’s currently on a weekend leave from her most recent rehab—in order to attend her sister’s wedding. Cue plenty of opportunities for emotionally loaded dysfunctional-type interactions.

Here’s the trailer to get you started:

Having seen and liked the movie, I appreciated reading the following review of Amy Biancolli‘s (Houston Chronicle) so much that I have to quote a significant chunk of it:

It hurts to watch Rachel Getting Married. It hurts because it captures, better than any film of recent vintage, the wild emotional undulations of life in a dysfunctional family.

It hurts because addicts are inevitably selfish, and movies about them are inevitably claustrophobic. It hurts because Anne Hathaway is rawer, bluer, meaner, truer, more broken than you’ve ever seen her — than you’ve ever seen just about anyone portraying a lost soul in recovery.

It hurts because Bill Irwin, the actor playing her father, seems to split down the middle as we watch. It hurts because Rosemarie DeWitt, as the Rachel getting married, conveys without an ounce of malice the outrage and exhaustion of loving someone who’s so far off from normal. And it hurts because our joy at seeing the warm, familiar face of Debra Winger turns to shock when her calibrated performance — as a detached mater familias — abruptly kicks into hellfire-spitting fury.

There’s a lot of other interesting stuff going on as well, including an underlying theme of a tragic family loss—for which Kym is held responsible.

And lots lots more is packed into the few days represented in this film. Wesley MorrisBoston Globe: “Demme and screenwriter Jenny Lumet have given us an epic rehearsal dinner, ceremony, and reception that’s half-cabaret, half group-therapy session, and completely multiracial, multicultural, and multisensory.”

This is one of those quirkier films that the critics loved and the non-critics not so much. It seems that having to sit through loads of family dysfunction is an undesirable for many—imagine that—especially if they already have that at home.

But I feel compelled to let another critic have the last word on this one. Michael Dequina, “The messiness that goes with genuinely flawed and complex people is what makes the film ring so true and cut so deep.”

Mar 28

“28 Days”: Hollywood Version of Addictions Rehab

Does anyone else remember when regular folks with addictions readily went to rehab for a month at a time? Often repeatedly?

Due to the high costs, whether you have health insurance or not, those days are now long gone for most people. Less expensive treatment options are generally now the norm. But we’ll always have, as a dramedy-type reminder, the movie 28 Days (2000). In this film, Gwen Cummings (Sandra Bullock), a writer for a city newspaper, messes up her life to such a degree that she’s forced into a rehab facility known as Serenity Glen. It’s that or jail.

Although this film received generally unfavorable reviews, there were elements that many viewers appreciated. Todd McCarthy, Variety:

…28 Days’ plays like a ‘Rehab Is Good for You’ promo feature offering the audacious suggestion that it’s preferable to live life with a clear head than with addictions and hangovers. Watching the ever-likable Sandra Bullock ride a predictable roller coaster from substance-abusing party girl to scornful rehab cynic to sober reformed citizen gives this smoothly made picture whatever appeal it possesses, but it’s a superficial, no-rough-edges account of a process that’s got to be a lot tougher than the month-in-the-country picnic depicted herein.

Here’s the trailer:

If you didn’t already pick up on it, rehab-speak runs rampant in 28 Days.

Jay Boyar, Orlando Sentinel: “’28 Days’ isn’t good enough or smart enough. But, doggone it, people just might like it.”

Charles Taylor, Salon: “It’s one of those movies that make you feel like you’re going through a therapy session.”

Gwen herself says while in rehab: “I am so tired by the way you people talk. You know, I mean, ‘one day at a time.’ What is that? I mean, like two, three days at a time is an option?”

Some of the best quickie lines come from Betty, the tough nurse played by Margo Martindale, when she announces over the PA system the upcoming educational topics. These often start with “Tonight’s lecture…”:

  • How many brain cells did I kill last night?
  • Are you a blackout drunk, or don’t you remember?
  • I’ve worked all 12 steps, can I go home now?
  • What’s wrong with celebrating sobriety by getting drunk?
  • Is God an alcoholic?

The following is a brief but more serious scene involving a group meeting that occurs after Gwen uses again:

It’s not uncommon for substance abuse counselors to be in recovery themselves, and this movie reflects this. At one point, top counselor Cornell Shaw (Steve Buscemi) tells a group of patients what it was like for him to be in the grip of chemical addiction:

…I would tell myself, ‘Tonight, I will not get wasted.’ And then something would happen. Or nothing would happen. And, uh, I’d get that feeling. I think you all know what that feeling is. When your skin is screaming and your hands are shaking. Uh, and your stomach feels like it wants to jump through your throat. And you know, that if anyone had a clue how wrong it felt to be sober, they wouldn’t dream of asking you to stay that way. They would say, ‘Oh, geeze, I didn’t know. Here. It’s okay for you. Do that mound of cocaine. Have a drink. Have 20 drinks. Whatever you need to do to feel like a normal human being, you do it.’ And boy, I did it. I drank and I snorted, and I drank and I snorted, and drank and I snorted, and I did this day after day after day after night after night. And I didn’t care about the consequences, because I knew they couldn’t be half as bad as not using. And then one night, something happened. I woke up. I woke up on a sidewalk. And I had no idea where I was. I couldn’t have told you the city I was in. And my head was pounding, and I looked down and my shirt is covered in blood. And as I’m lying there, wondering what happens next, I head a voice, and it said, ‘Man, this is not a way to live. This is a way to die.’

Although it’s been many years since I saw this film, I do remember kind of enjoying it despite its flaws. And, judging by a lot of consumer reviews online, so did many others.

Mar 27

“Postcards from the Edge”: An Addict Always Has Enablers

Postcards From the Edge, a 1990 comedy adapted from the semi-autobiographical novel by Carrie Fisher, features Meryl Streep as Suzanne, an actress struggling with drug abuse. We can only imagine Suzanne’s pre-rehab experiences with her presumed enablers, as the movie deals more with post-rehab.

But the movie does start us out with a bit of rehab—which Suzanne has more than earned. One of Suzanne’s best and most-quoted lines: “Instant gratification takes too long.”

Vincent Canby, reviewer for the New York Times, notes about Suzanne’s treatment:

Suzanne doesn’t minimize her predicament, but she can’t help standing a bit outside it. When a therapist suggests that a group encounter session be ended so the patients can visit with their ‘significant others,’ Suzanne wants to know why everyone has to talk in bumper stickers.

When she’s discharged and finds out that she has to live with her mom Doris (Shirley MacLaine) in order to keep her current film-acting job, she’s deeply chagrined. Much of the ensuing plot is about the strained mother-daughter relationship, in fact.

Doris drinks problematically, although she denies being an alcoholic: “I just drink like an Irish person.” A well-known entertainer herself, Doris is also self-absorbed, controlling, and overshadowing of her daughter.

You can see the film’s trailer below:

Postcards From the Edge offers glimpses of some common intergenerational family dynamics of an addict. We find out, for example, that Doris started giving Suzanne over-the-counter sleeping pills regularly when she was only nine years old—a great way to set up eventual addiction issues in one’s offspring. And when we meet “Grandma,” Doris’s mom, it becomes pretty clear how Doris became the parent she is.

The review from Variety concludes that this movie “(p)acks a fair amount of emotional wallop in its dark-hued comic take on a chemically dependent Hollywood mother and daughter.” If you want more depth, however, you might actually prefer the novel. It’s a quick, witty read that gives us additional info about Suzanne’s rehab and therapy.

Mar 26

Charles Duhigg: “The Power of Habit” and How to Make Effective Changes

Change might not be fast and it isn’t always easy. But with time and effort, almost any habit can be reshaped. Charles Duhigg, The Power of Habit

A recent feature in The Onion pokes some fun at the public response to Whitney Houston’s autopsy report. One person says, “The real tragedy is that she isn’t still alive to hear my opinion about her death.”

There are some opinions that matter, however—if they can help shed light on ways to prevent similar tragedies, for instance. Following Houston’s deathCharles Duhigg, New York Times reporter and author of a relatively new book about habits, speculated about the reasons behind her ultimate failure to reap the benefits of repeated rehab—and more specifically, why 12-step programs didn’t work adequately for her.

First off, he points out that any “habit loop”—whether drinking or drugging or something else—consists of a cue, a routine, and a reward. Taking alcoholism as an example of a habit/addiction, he states that groups like AA (or NA or GA, and so on) often provide a way to form new but similar habit loops.

Many alcoholics, say studies, essentially suffer from habit dysfunctions. They have learned to react to a cue (‘I’m stressed. I need to relax at a bar.’) with a routine (‘Bud Light, please.’) to receive a reward (‘I always feel better after unloading to my friends over a beer.’)

A.A. just tweaks that formula slightly. There is a still the same basic cue (‘I’m stressed. I need to relax at a meeting.’), a slightly different routine (‘My name is Jim, and I’m an alcoholic.’) and, essentially, the same reward (‘I always feel better after unloading to my friends over coffee.’)

So, here’s why support groups may not have worked for Houston:

…(W)hat Ms. Houston couldn’t do — because her life catered to the belief that she was peerless, the star of the show, an incomparable diva — was find a group of peers whom she could compare herself to, and believe that if they can struggle and persevere, so can I. Her life was not constructed to subsume her ego into the communalism of a group. And so she never found a safe place to practice believing she could change. And so as soon as the pressures hit, all the new habits broke down, and the old patterns took over.

Whether Charles Duhigg has nailed Houston’s particular issues or not, The Power of Habit: Why We Do What We Do in Life and Business, contains important wisdom for those stuck in unwanted habits and addictions.

As Kirkus Reviews points out, Duhigg’s all about the brain science:

…Duhigg demonstrates how automatic behavior, good or bad, can grow from a repeated decision that gets lodged in the basal ganglia…Animal trainers are already familiar with this information. For improvement, the trick is to keep the cue and reward, but change the routine. The belief that acquiring a new ‘keystone habit’ can really be achieved is necessary…

Cultivating the belief that the habit can be changed is where the power of support groups comes in. People go to them, hear others speak, and start to believe that if others can get better so can they. David Allen, author of Getting Things Done: The Art of Stress-Free Productivity, on reviewing Duhigg: “His chapter on ‘keystone habits’ alone would justify the book.”