I'm Little_Dog. Not an alcoholic.
May 29, 2014 9:41 AM   Subscribe

My therapist has recommended I regularly attend AA meetings. While it's true I quit drinking nearly 4 years ago, and alcohol had been a prevalent and destructive force in my life at that time, I have never experienced anything like a craving to drink in all the time I've been sober. My M.O. has always been a, "Eh, I'll have a drink when and if I ever feel like it. Which will probably be never, because I love this clear-mindedness!"-sort of thing. The therapist is treating me as a patient "in recovery". Fair enough: She can use whatever approach she sees fit, but now I'm entertaining the idea of AA and simultaneously questioning whether the therapist is a good fit for me. Yes, there are more details.

I'm a woman, nearly 34-years-old, and I started seeing Anna (*fake name) last January because of general unhappy feelings w/r/t relatives. Anna and I did some good work together, meeting 2-4 times per month. The last two sessions, however, have been really uncomfortable for me, and I've been thinking about it to death-- Am I uncomfortable because the hard work is starting? Is she testing me...?

So, to boil this down to a question or 2, I'm wondering how beneficial it might be for me to go to AA meetings, and I'm wondering (again. Sort of been here before) when to end it with a therapist and not feel like I'm a quitter; self-destructing by doing so?

I went to an Open Discussion AA meeting earlier this week, and I've been to maybe 5 or 10 meetings in my life, when other non-drinkers encouraged me to check out a meeting with them because they swear it works really great and if I keep coming back I will see that AA works really great.

I don't doubt that AA works really great, or that it's nice to experience that kind of fellowship and support. I do seriously question, however, if it's the best way to spend *my* time, personally, because staying sober-- Staying sober isn't really a Thing to me. I neither struggle to stay sober, nor care if I do, I just quit drinking, you know? Yes, I relate to every single story I've heard in AA. The folks in 'the halls' and I have a lot in common.

My therapist has told me that I'm an overall healthy and well individual. But, that the issues I most struggle with are the direct result of my using alcohol and pot for a lot of my life (age 13 to 30). She's used the term "emotionally stunted" to describe how I stopped developing and maturing at, basically, age 13. So, she recommends I get support from attending AA or NA meetings, and has established "clinical boundaries" that anything she and I discuss in session has to strictly fall outside the category of alcohol-related. Which, if you follow, she says everything in my life is. Everything in my life is related to previous alcohol use and abuse (she says. After all, I'm "emotionally stunted" and all my issues reflect my emotional underdevelopment). So, the last two sessions has been a lot of meta-talk. Talking about how we can't talk about anything.

I'm 99% sure that I want to do the following: I want to thank Anna for the great work we've done in the past six months, and terminate treatment on account of our relationship having run its course. Attend weekly AA meetings, because to give it a real fair shot I have to tell my story; open my mouth and actually participate, and after a real fair shot I can determine if it's worth pursuing. And, finally, seeking fellowship elsewhere. I'm hardly a social person. We heal by telling our stories, and currently I barely talk to real people about personal things, so-- rather than AA 4x a week, I can find other means to connect with, you know, other people.

My fears and questions: Is it fraudulent (or just fkng stupid) to hang out at AA meetings with neither a commitment to sobriety or a need for help to stay sober? Am I being stubborn and pig-headed here, where this shrink is trying to help me and I'm just not letting myself be helped? Thanks for reading.
posted by little_dog_laughing to Health & Fitness (46 answers total) 5 users marked this as a favorite
If you've had not a single drink in 4 years why not check in with them, get one of the annual tokens. Then just keep checking in annually and keep the current token, just so if you ever need to you'll have a reminder. Just a thought.
posted by sammyo at 9:47 AM on May 29, 2014 [2 favorites]

If it's not broken, don't fix it.

Your relationship to your sobriety is unbroken, fine, & dandy.

Your relationship to your therapist sounds seriously messed up. She's become weirdly controlling, and you seem in danger of developing Stockholm syndrome (Am I uncomfortable because the hard work is starting? Is she testing me...?). Follow your instincts and break up with her, pronto.
posted by feral_goldfish at 9:54 AM on May 29, 2014 [12 favorites]

It sounds like you're not really connecting with this therapist and you should do what you want to do.
posted by A Terrible Llama at 9:55 AM on May 29, 2014

Hey Little-Dog,

AA works for some people, and it's not indicated for others. If YOU'RE happy, and you don't feel that you need AA, then good on ya.

I understand about being emotionally stunted, and those are things you'll always work through. I'm forever reminding one of my friends about the fact that she's approaching an issue from the point of view of a teenager. FWIW, she's not in AA either.

How about you say to your shrink, "While I agree, there are emotional maturity issues that I need to work on, after attending some AA meetings, I don't find that they resonate with me and I don't want to continue on that path."

If your therapist is cool with that, continue on if you like her. If she gives you static or pushes back, it's time to find someone you're more sympatico with.
posted by Ruthless Bunny at 9:56 AM on May 29, 2014 [3 favorites]

My therapist has told me that I'm an overall healthy and well individual. But, that the issues I most struggle with are the direct result of my using alcohol and pot for a lot of my life (age 13 to 30). She's used the term "emotionally stunted" to describe how I stopped developing and maturing at, basically, age 13. So, she recommends I get support from attending AA or NA meetings, and has established "clinical boundaries" that anything she and I discuss in session has to strictly fall outside the category of alcohol-related. Which, if you follow, she says everything in my life is. Everything in my life is related to previous alcohol use and abuse (she says. After all, I'm "emotionally stunted" and all my issues reflect my emotional underdevelopment). So, the last two sessions has been a lot of meta-talk. Talking about how we can't talk about anything.

This is so nonsensical that either your therapist is criminally incompetent, or you're (consciously or not) misunderstanding what she is actually trying to say. Which, to me, would indicate that you need to keep working through that with her. (If you feel she's been a shitty communicator all along, that would change my opinion, but I think you'd likely have mentioned that if that were the case.)
posted by jaguar at 9:58 AM on May 29, 2014 [6 favorites]

I think dropping the therapist is the correct decision, given that she is unwilling to help you deal with the "emotional immaturity" she has diagnosed. Maybe try to find another therapist, in addition to checking out AA. You sound pretty clear-headed, actually, and it's great that you were able to quit the self-destructive alcohol use. Best of luck.
posted by Johnny Wallflower at 10:00 AM on May 29, 2014 [3 favorites]

It may be that your therapist subscribes to the "Dry Drunk" theory, which is that you can have all the dysfunction common to alcoholics while not actually drinking, and that the participation can provoke growth and healing in ways that seem to be particularly beneficial to alcoholics. I've heard AA-adherents talk about recognizing them in the wild.

It is certainly a legitimate reason to attend - after all, people who've been sober for 20-30 years may still attend meetings - but it is also not the only option available to you. Maybe it's worth a conversation with your therapist about why she thinks it's a good idea and why you don't, as there might be some feelings to root around in there.
posted by Lyn Never at 10:00 AM on May 29, 2014 [7 favorites]

Nthing that AA is not essential to every person who quits drinking. I've know people who drank like fish for years, quit cold turkey, never attended AA, and never had a problem down the road. Basically they had the attitude you have. It can work, it's working for you, so stick with it.
posted by beagle at 10:00 AM on May 29, 2014 [3 favorites]

In continuing to try to parse that: Is she trying to get you to focus on your childhood and adolescence in sessions? If so, she may be wanting you to have the additional support of AA right now because dredging up past events and emotions that led you to start using in the past might trigger that desire again, and so she might be wanting to make sure that you stay sober and stay supported while you do the work you need to do.
posted by jaguar at 10:02 AM on May 29, 2014 [3 favorites]

It seems incredible that she would be unwilling to help you with what she has deemed to be your core problems. If AA is what you need and she won't help, then why are you seeing her?

Anyway, it sounds like you disagree with her assessment judging by your use of scare quotes. Find another therapist who you feel more in tune with.
posted by mymbleth at 10:04 AM on May 29, 2014 [1 favorite]

Basically, quitting drinking does not mean that a person has automatically dealt with the issues that caused them to drink, or developed the coping skills that would allow them to deal with those issues without drinking. A therapist working with a former alcoholic has every reason to be concerned about the emotional and behavioral fall-out that can happen while working on those issues or working to develop those coping skills, and referring the client to additional resources and support during that time is a very valid and caring action.
posted by jaguar at 10:05 AM on May 29, 2014 [8 favorites]

I read the question and was going to chime in here. I am so glad to see teh answers you have been given. In fact sammyo and feral goldfish have already said what I came in to say.

fwiw I was married to an alcoholic abuser and discovered that I neither needed the relevant AA group nor was I codependent etc. that was "expected" of someone in my theoretical position. Primarily due to cultural differences such as the fact that it was an arranged marriage not an 'emotion driven' one. I also found I outgrew my therapist after a certain point of time. Go with your gut on that.

you sound like you're in a good space and there's a lot to be said for time and natural forces working together to complete the healing process.
posted by infini at 10:06 AM on May 29, 2014

Came in here to mention the 'dry drunk' personality which is a person who hasn't taken responsibility for his/her actions & feelings, despite 'not having touched a drop for years.'

It may be helpful for you to check out AA 'just to see', and I have also met people who curtailed their drinking considerably without it.

I would imagine that it's ok to attend without drinking the kool-aid about it.

You mention that the last few sessions have felt uncomfortable however, so it might be wise to fully examine that discomfort before terminating your relationship with Anna. It could be a genuine clash, it could be they are hitting up on some deep defenses, it depends.
posted by St. Peepsburg at 10:08 AM on May 29, 2014 [1 favorite]

when to end it with a therapist and not feel like I'm a quitter; self-destructing by doing so?

FWIW, here's my experience of breaking up with a therapist:

She did not take it well. She told me I was making a mistake, that I was in denial, and that I needed serious psychoanalysis, the kind where you go to therapy every single day. I switched to a cognitive-behavioral therapist, got better meds, and over the next year I finished & defended my PhD dissertation, and landed a decent job. It was pretty much the opposite of self-destruction.

Quitting can be like that. As you've already experienced.
posted by feral_goldfish at 10:12 AM on May 29, 2014 [11 favorites]

This is kind of a weird question to me. I'm 100% not a professional anything(*), and this isn't medical advice, but... most therapists I know probably wouldn't have drawn a line quite like this, as presented. If I had patients (*) who had previous alcohol/etc abuse but did not drink/etc now, I'd try to work on their issues, with the patient as they are now. I also know a 100% zero tolerance is needed for a lot of addicts. No, they CAN'T have the one drink if they feel like it and stop. Perhaps this is what she is aiming for?

So... I'd say that her diagnosis of 'a little stunted at 13ish' is probably/possibly fair. What caused you to start drinking/etc at 13? (you don't have to answer in-thread, but it is something you should probably be aware of) A lot of times that can be caused by something- divorce, trauma, life changes, etc.... and people often do get 'stuck' there, and unconsciously re-enact that hurt. I'd probably have another session, with a good talk about the what, the why, what she expects from AA and future therapy.... And if yall just can't work it out, so be it.

(*)I'm 100% not a professional anything(*)
posted by Jacen at 10:13 AM on May 29, 2014 [1 favorite]

This is just practically a reflex for a lot of people - they think that anyone, with any substance abuse issues whatsoever, should be going to AA. It is an article of faith for them.
posted by thelonius at 10:16 AM on May 29, 2014 [3 favorites]

I attended six sessions with a therapist a few years ago. My goal was to explore some compulsive cleaning behaviors and related anxiety. The therapist quickly decided that the cause was rooted in my father's alcoholism during my childhood. The only problem with that theory: my father was not an alcoholic during my childhood.

She had me buy a book and then wanted me to go to Al-Anon. When I expressed skepticism, she told me that she couldn't help me any further because I wasn't ready to deal with my issues.

So, some therapists are not a good fit. Some therapists view their clients through a particular lens so that everyone's issues appear to be caused by the same thing. I found a second therapist who worked out much better for me. I think you should find someone new--or maybe take a year off and then see whether you still feel inclined to work with someone else. Good luck!
posted by The Minotaur at 10:18 AM on May 29, 2014 [2 favorites]

You actually attended a meeting and didn't see how meetings could help you. You can ask her to be more specific about why she thinks it would help. A therapist's suggestion should be just a suggestion. I think it's much better if they don't actually tell you what to do. You get to choose how to proceed.

Some former drinkers get a lot out of AA and its principles -- accepting that you can't change certain things, trying to make changes where one you, keeping things in perspective. If you don't believe you'd benefit from going, then it's unlikely to help you.

A huge plus in therapy is learning to interact with your therapist in ways that have been difficult in the past with other people. If you feel like you're being told what to do, or if you see your therapist's advice as being off the mark, talking about that is therapeutic...whether you end up continuing with this therapist or not.
posted by wryly at 10:19 AM on May 29, 2014 [3 favorites]

she established "clinical boundaries" that anything you discuss in-session has to be strictly non-alcohol related, and then she told you to go to AA? did i read this right? wtf?

i weathered exactly one dozen AA meetings because the judge ordered me to. i was utterly unaffected by them.

you're in charge of the therapy relationship. she's told you that you're an overall healthy and well individual. time to pull the ripcord!
posted by bruce at 10:19 AM on May 29, 2014

Best answer: I am a therapist. I can think of no valid reason* that any therapist would establish the kind of "clinical boundaries" you describe that don't boil down to essentially not wanting to work with you on the things you want to work on. That's ok, but the therapist should terminate themselves at that point. You should absolutely terminate with them and then do whatever the fuck you want.

* There are some addictions or mental health workers who feel that addictions and things related to them can only be discussed in the context of substance use treatment. Those people are wrong and intellectually stunted, and should be avoided because they lack an appropriate understanding of psychological processes. In this case, even that motivation fails, because those types of providers do not consider 12-step programs to be substance use disorder treatment.
posted by JohnLewis at 10:24 AM on May 29, 2014 [13 favorites]

The decision about whether AA would be a thing you'd get something out of is your own question to answer.

Do you feel like you need the thing that AA "works really great" at doing? Do you feel like you would benefit from the support it provides?

To me, this sounds kind of like if someone hears that you run marathons and recommends that you get a pair of Vibram 5-Fingers. Some people like those shoes a lot and really swear by them. And buying a pair of shoes isn't the end of the world -- they're just shoes, after all. But just because these are shoes, and a lot of people like them, and you are a runner, that doesn't mean these particular shoes are going to be relevant to you, your feet, the kind of running you do, etc.
posted by Sara C. at 10:28 AM on May 29, 2014

Best answer: The stopping drinking part of AA is only one part of it. I would suggest your therapist might think that the other aspects of AA would be helpful to you. Say taking a moral inventory, making amends, giving things over to a higher power. If she is wanting to start dealing with the problems that caused you to drink in the first place she may also want you to have a support network in place.

Annedotally, my father drank and was a functioning alcoholic for pretty much the first 22 years of my life. He stopped cold turkey, like you he just stopped drinking without any support group, and considered he didn't need one. Because he had not learned any coping skills or resolved the issues that made him drink in the first place (childhood abandonment we found out about only after he died) he became a gambling addict instead and gambled away all his money by the time I was 30.

Maybe you don't need the meetings, maybe the things that made you take drugs and drink in the first place won't be helped by what AA can do, but would it hurt to go for a few months and see if there isn't something in there.

Having said that your therapist sounds very unhelpful and if nothing else is not explaining things clearly to you, that alone would be reason for me to start looking for another one.
posted by wwax at 10:29 AM on May 29, 2014 [4 favorites]

Best answer: About the emotional development piece: I'm not on my school laptop so I can't access my Endnote library, but there is some interesting research out there supporting her point that addiction impairs neurological development. This is something I was able to find pretty quickly, since I'm imagining she's talking about nueroplasticity? Anyhoo, basically the argument is that your brain gets stuck at that stage because your dopamine receptors are used to these big huge rushes delivered by your addictive substance of choice.

Think of it kind of like a footpath in the forest. For the last few years you've had giant construction vehicles smooshing down all the trees and the bushes, so what should be one footpath out of many is like a a big road -- it's wicked convenient for your dopamine to go down this road, but that means you use it faster and get a bigger down when it's gone. So

1. she might be saying, hey, you're not addicted to alcohol, but you're looking for a dopamine kick in all the wrong places, like in toxic relationships or risky behaviors sexually.

The other side effect of this footpath becoming an artificial road is that you don't know how to maintain the road now that it's gone. So

2. She might be saying, hey, in your sessions with me, we're going to practice some strategies designed to encourage your neuroplasticity/ability to activate and send dopamine hikers down these roads that should be footpaths. We're gonna focus on those behaviors that distract you from this nature hike... it's gonna be quiet and calm and strategies for life. And you should use your AA sessions to talk about the big trucks that hurt your mental forest -- who/how they were invited in, the havoc they wreaked on the eco-system of your brain (both re: emotional development, executive function, and memory), and how this clear-mindedness has effected your life.

I'm sorry this is so long; my ex-husband was like you in that he claimed he was no longer an alcoholic, and in fact he rarely drank during the 5 years we were together. HOWEVER, he replaced the alcoholism with massive highs and lows -- risky behaviors, drama-riffic work controversies, and ultimately an affair/baby outside our marriage. He stopped drinking but he never focused on that internal stuff, where he learned to be happy with himself. That's really what all that neuroplasticity stuff means, OP. During high school and early twenties, non-addicts are learning who they are and how they can cope with the "background feelings" of being a conscious person. Handling these background feelings is wicked important because they help you have a continuous sense of self (Damasio talks about this in The Feelings of What Happens) When you can't regulate/make sense of these background feelings by integrating them into your core sense of self (because they're uncomfy, unfamiliar, or whatever), you turn to big conscious feelings (the drama!!! of everyday life!!!!! only it shouldn't be drama!!!!!! because it's everyday life!!!!!!) to artificially make this sense of continuous self happen.

So anyways, I don't know you and I don't really know whether you should break up with your therapist. I do know from my own research and my own life experience that the "not drinking" is only part of the problem. I really hope this long post helps (and also made sense... so... many... allergy... pills...) and that you continue on in therapy, even if it's not with Anna.

I also want to say I'm very proud of you for quitting drinking. It's an amazing accomplishment and a major life style change. Regardless of whatever happens, be proud of yourself for that.
posted by spunweb at 10:46 AM on May 29, 2014 [12 favorites]

If you are having issues with getting over events that have happened in your past and continue to haunt you, that is what she should be focusing on, period. You haven't had a drink if 4 years, you clearly acknowledge it was a destructive force in your life at that time, and now it is time to do some other work to understand your thoughts and behavior. It sounds like your therapist may be the one who is "emotionally stunted" and not able to move on past the "dry drunk" diagnosis, a term I really find unhelpful and I hope she never uses that term with you!
posted by waving at 10:47 AM on May 29, 2014 [2 favorites]

You come across as sensible and capable. I am inclined to think your therapist is, er, no longer helpful (rather than you misunderstanding/misrepresenting what actually happened there). Your "99% sure" plan sounds reasonable to me. Good luck.
posted by mattu at 10:58 AM on May 29, 2014 [1 favorite]

I'm going to give you some gold here, and I want to qualify that I am usually not the person to make this type of comment.

AA is not just about going to meetings. It is about working the steps, and that's really about building a relationship with someone you trust, over time, to start working on your character defects, so that you can get rid of them and live a happier and more meaningful life, that includes new friendships, in a way that feels genuine to you, and isn't just about dumbing yourself down to a bunch of "articles of faith" and putting on a performance for other people. This is something that AA and other 12-step programs offer, for free, if you seek it. And perhaps not without some perseverance and challenges along the way.

So that if you are looking to dump your therapist and find "the answer" by being a slightly more anonymous "member of a group" and "checking in through shares" and "listening to story-telling," I'm here to tell you that while that helps, it's not the alpha and omega of 12-step recovery and you should be very wary of the tack you're taking, if that's all you seek. You've got to give recovery a real shot.

If that resonates with you, I would suggest checking out Al-Anon. This is a great list of 20 questions you can answer, and if you want, you can replace "problem drinker" with "problem person." You don't have to make any "big decisions" in order to go to a meeting. If I may be so bold, you may find that your recovery is your responsibility in that program. It's a little more on your terms, and that alone may give you the space to dig into some new feelings you didn't even know you had. I also want to complicate things further by mentioning that it is not only other peoples' "active drinking" that is up for discussion, but their sobriety as well. So you don't disqualify for Al-Anon if, say, you're an isolator and nobody in your life is actively drinking.

And I'm not trying to talk down to you, but denial is a huge, real thing. Just because you walk away from your therapist doesn't mean your life is going to automatically improve. Sometimes, even if all we see is the fault in the other person, we have to admit that these situations are of our own making. In a way, thank God for patterns. You wouldn't be asking this question if you weren't approaching a tipping point. Wishing you the best.
posted by phaedon at 11:02 AM on May 29, 2014 [4 favorites]

Being powerless over alcohol is the essential premise of AA participation and admitting you're powerless over alcohol is the essential behavior of an AA participant in recovery.

If you are not, in fact, powerless over alcohol, than AA is not for you. Someone who can go four years without drinking is probably not powerless over alcohol, no matter how much damage you did to yourself or others while drunk before that.

There are many people who drank like fish for years who for reasons sufficient for themselves stopped drinking or cut down their drinking dramatically with no form of structured recovery.
posted by MattD at 11:05 AM on May 29, 2014 [1 favorite]

I'm a therapist who specializes in treating trauma, and I do not in any way believe in the "once an addict, always an addict" thing, and while I think it's great that many people find help in 12-step programs, I know that other routes to recovery have been shown equally helpful.

I also know, however, that the number-one coping mechanism my clients use when faced with resolving past traumas (or current ones) is alcohol. By a ridiculous overwhelming margin. People who do not have drinking problems still often become problem drinkers when facing seemingly overwhelming negative feelings and events. A therapist who thinks a client needs to work on past traumas absolutely needs to monitor that client for problem drinking, to make sure it's not creating major problems in the client's life, and that goes fifty-seven-eleven times more for clients with past addiction problems. (Clients with current addiction problems shouldn't even be doing deeper trauma work.)

I know there's a big bias on MetaFilter for present-focused cognitive-behavioral therapy and an attendant assumption that therapists should all focus on current problems, but past traumas influence current behaviors and beliefs, and therapy often does need to dig in and get at what happened in the past. Responsible therapists will make sure clients have lifeguards and life-preservers and rafts and ropes and such available before they even start dipping their toes into potential dangerous waters.

OP, if none of my comments about the possibility of your therapist wanting to make sure you're safe before you start working on past issues fit in with what you two have actually talked about working on, then that's fine and you can ignore me. But please at least consider it a possibility that "outside the category of alcohol-related" means "before you were 13 and started drinking" and that she's pushing AA because it'll give you someone to call at 3am when you're feeling overwhelmed and wanting to drink because of what you discussed in therapy.
posted by jaguar at 11:07 AM on May 29, 2014 [12 favorites]

You mind find The Truth about Addiction and Recovery a useful read. People I have spoken to who ascribe to the AA "disease" model tend to be not fans of it. I think it has something to offer for folks who are not fans of AA.

My dad stopped drinking when I was 7 years old. He did so "cold turkey" and never attended AA. After that, the only time he drank beer was a few sips many years later to teach my brother a thing or two about what constitutes good beer.

I think he drank heavily while in the army because he fought in the front lines of two wars. I think he drank to suppress the nightmares so he could sleep. He retired from the army when I was three. I recall him having a beer with dinner when I was little. I do not recall him drinking to alcoholic levels like the family stories indicate he did for many years while still in the army. I suspect he began tapering off of alcohol as soon as he was out of the army and no longer had to live in fear of being sent back to Vietnam. I suspect that by the time he was diagnosed with a heart condition (when I was 7), decided to blame it on his drinking and officially swore off alcohol, he had largely already quit drinking. He was a high school drop out and did not spend lots of time analyzing the whys and wherefores. He just quit and got on with his life (as best he could -- he probably could have used therapy for PTSD related to serving in the front lines).

I have read similar stories in articles. One that stands out in my mind: A guy's brother was gruesomely murdered when the guy was 16. He suddenly began drinking heavily. About 2 or 3 years later when he was 18 or 19, he was ready to "admit he was an alcoholic and seek treatment for his drinking" which sounds to me like he was sufficiently recovered from the shock and trauma of his brother's horrific and sudden death to be able to stop drinking and sleep nights and not be kept awake by nightmares. But no one was telling him he drank to cope with the trauma. They were telling him he drank because "he was an alcoholic" (aka badly behaved person doing something pathological for no real reason).

So, suffice it to say, I do not ascribe to the AA "disease" model. I think people do things for a reason. They often do not consciously recognize why they drink but when the real reason they drink gets resolved, they often just stop drinking, AA or no AA.

I will also say that the single most important thing I figured out while in therapy is that therapists are human. Just like anyone else, they have personal bias, they are fallible, etc. You can't let them tell you how to live your life. If talking with one is useful for you, awesome! If it stops being useful, do not deify them. Move on, just like you would if your doctor or dentist or auto mechanic was not doing satisfactory work.

So I don't see any problem with you quitting therapy with this particular therapist and also not going to AA if you don't want to.
posted by Michele in California at 11:09 AM on May 29, 2014 [7 favorites]

It is easy to get the idea that your therapist is an expert not just on something about mental health but about your mental health specifically, and thereby to feel guilty about questioning them, but I think most people who've had good long-term results from therapists have gone through several of them. I think you'd do well to look for someone who's a better fit.

This part is entirely speculation, but, well, I have found that the people who have the most faith in AA's ability to help people better than anybody else, including mental health professionals, are the people who are themselves longtime participants in AA, or sometimes who have close friends or family members who are. I'd call it extremely unusual for a therapist to say "you need to address this in a twelve-step meeting and NOT here in therapy"--lots will encourage you to go to meetings if you have substance abuse problems, mind, but not to avoid dealing with the subject in therapy.

AA and other twelve-step programs work for some people, but I have never seen anyone cite any kind of reliable data to back up the idea that AA is the only acceptable way to deal with having had an alcohol problem. Some people clearly believe that, but honestly, the meetings are out there if you need them at some point later, that doesn't mean that's going to be useful to you right now. I think you just need a new therapist.
posted by Sequence at 11:14 AM on May 29, 2014 [2 favorites]

Really agree with Jaguar.

Here's another antihistamine induced metaphor:

Think of your alcoholism like a big piece of plastic wrap on the mouth of the jar filled with your anxieties, fears, experiences, hopes, and goals. They're pebbles in this jar, and they're all dirty and dusty because you haven't been able to rinse them off because there's this plastic wrap on the lid of your jar. There might be gold nuggets, mica (which is pretty, don't hate on fool's gold!), awesome quartz, or even fossils and arrowheads and seashells. You can't tell because it's all dirty and the plastic wrap and the dirt is all you can really see right now.

Your therapy sessions are like water, and they're to help you rinse off your pebbles and the sides of your jar so you can see in. Only, instead of getting INTO the jar all the water of your sessions is collecting on the plastic wrap. It's keeping the conversation in session stuck (because honestly, was talking about how you don't have a problem worth two sessions?) and it's keeping you from doing the work you want to do: getting to know past you and present you without this plastic wrap in the way.

So what your therapist is proposing is that YOU remove the plastic wrap yourself -- find a place to stick it and examine it and see how and why it stayed on your jar for so long (is there tape? is there more than one layer? has it started to develop a new ecosystem isolated in its folds, nooks and crannies?) so that you both can start the process of examining the stuff in your jar -- the stuff that you haven't looked at because you've allowed your own focus on your past struggles with abuse to be the object of your fascination -- and so that you can start developing the neuroplasticity skills to self-manage the feelings talking about your alcoholism brings up outside the context of the therapy sessions.

Also, re: Jaguar's final point: your therapist needs you to have an external support network when you start looking at your pebbles, because you will absolutely need someone to talk to at 3 am if your sessions start to uncover really hard, serious stuff. Even if you break up with this therapist you will need this support network if you want to go further on your mental health journey, because eventually you will get to talking about why you started drinking at thirteen and why you kept it up for 17 years. This is probably not going to be the funnest conversation ever, and you will need people in your life who can help you process these feelings without judging you. Your therapist can't be the person who helps you process your therapy sessions at 3 am because they need to be distant enough from you to maintain professional boundaries AND because making friends/developing a support network is part of the social skillset many alcoholics don't learn how to do... so being that person for you actually won't help you grow, while encouraging you to find people who CAN be that DOES.

You aren't going to get that kind of support you will need right off the bat from a more anonymous context than AA. Outside the support group context it takes years to create that kind of bond. I think that is why your therapist is suggesting AA.
posted by spunweb at 11:39 AM on May 29, 2014 [6 favorites]

Former chronically cross-addicted alcoholic, with two (or more) cents to share.

It may be that your therapist subscribes to the "Dry Drunk" theory, which is that you can have all the dysfunction common to alcoholics while not actually drinking, and that the participation can provoke growth and healing in ways that seem to be particularly beneficial to alcoholics.

This can definitely be an issue with some alcoholics who've quit more-or-less completely solo. It could be that your therapist is seeing evidence of this in your sessions (excessive or misplaced anger, shame, self-deception, etc.) and feels that AA might help. I'm not getting that vibe from your OP, but I'm also neither you nor your therapist. If you do some honest self-assessment, can you see those sorts of traits at play? If so, she might be on to something.

As for being "stunted," I personally feel that I experienced this side-effect of addiction; during recovery, I noted that some aspects of my construct of reality were stuck at roughly the same level as when I was 13 -- 20 years old (the period between first experimenting with substances and the time I began constantly steeping in them). On the other hand, there are certain kinds of wisdom that arise from surviving an addictive hellscape of a life. In a nutshell, there are negative (and some positive) ways in which chemicals rewire us, and they should definitely be recognized and addressed, regardless of format.

AA ain't for everyone. Participating in the program for the first few years of my sobriety was very helpful, because I needed the negation of ego that it provided: Working on avoiding judging others in the group, working on sharing openly with strangers, subsuming my will to the directives of a sponsor who wouldn't give me a pass on various intellectual/philosophical dodges; all of these helped me get past myself and get healthier. Then, gradually, I found it to be less necessary. I haven't been to a meeting in over five years (of nine, and counting), and have zero interest in drinking ever again. Other people use AA (or similar programs) for the rest of their lives. Not my choice, but whatever works, right?

I'm not seeing evidence from your OP that you have any antipathy towards 12-step stuff, in principle; you've gone to some meetings and are able to recognize their value to others (and your similarities to same). If you were openly hostile/dismissive, I might be pushing for you to "give it a chance," myself. It sounds like you have, though. (One caveat: "Open meetings" are a different animal than involvement in an ongoing "home group," where you really get to know/trust people, and where most members are going a bit deeper in their work than just admitting powerlessness.) Going solely off your statements, I don't think you would be out of line to stand firm on this with your therapist. She's a fallible human, too, and maybe she's failing you by pushing this particular solution so hard. I mean, is she only charging you for the things she's willing to talk about? I'm unclear on the ethical structure of this sort of relationship, but if you're paying her she probably shouldn't have total control of the direction of a given session.

... I can find other means to connect with, you know, other people. I get this. I was sort of uncomfortable with the group sharing aspect of AA, myself. As I mentioned above, it was really helpful to me to be challenged in precisely this way. Worth considering. But you're right: There are lots of ways to connect and engage in mutual support, in the modern world. This place, for example.

(On preview of the comment above mine, it's absolutley worth noting the difference between face-to-face/twenty-four-seven support and the more truly anonymous/not-real-time kind found on the internets.)
posted by credible hulk at 12:29 PM on May 29, 2014 [3 favorites]

The more I think about this, the less coherent her position seems. She says you are basically healthy, but have issues that are all coming from years of drinking/using? But she won't address them, because you should do that within AA? What does she propose to do therapy about, then? The only way this makes sense is if she draws some sort of distinction between "the category of alcohol-related" (which she wants to make off-limits) and "the issues.....[that]...are the direct result of my using alcohol and pot for a lot of my life", and I just don't see what that distinction would be.
posted by thelonius at 3:21 PM on May 29, 2014

Is it fraudulent (or just fkng stupid) to hang out at AA meetings with neither a commitment to sobriety or a need for help to stay sober?

Well, my mom not only isn't an alcoholic, and not only do we not have alcoholism run in the family at all, she doesn't even drink whatsoever. And hell, she's gone to AA meetings both with a friend and alone--someone recommended she go to deal with her codependency issues. So at least in my hometown, nobody cares if you go to AA and are not worrying about staying sober.

So, she recommends I get support from attending AA or NA meetings, and has established "clinical boundaries" that anything she and I discuss in session has to strictly fall outside the category of alcohol-related. Which, if you follow, she says everything in my life is. Everything in my life is related to previous alcohol use and abuse (she says. After all, I'm "emotionally stunted" and all my issues reflect my emotional underdevelopment). So, the last two sessions has been a lot of meta-talk. Talking about how we can't talk about anything.

Okay, so basically she wants you to go to AA as some kind of alternate support group. That isn't totally unreasonable. I do think it's a little weird that she refuses to talk about anything related to the alcohol, though. Is this not a topic she can cope with? It kind of sounds like she wants to pass the buck or isn't up to dealing with it. And if that is the case, then yes, I think you need to tell her you need to discontinue. Whether or not you want to go to AA is optional--I don't think it'd hurt to give it a few tries once in awhile even if you're not feeling the urge to drink, though I'd ask her why it is such a big deal to her that you go. But mostly I think the problem here is that it sounds like she's unable to discuss an area of your life, and that's not a good shrink move.
posted by jenfullmoon at 6:35 PM on May 29, 2014

she recommends I get support from attending AA or NA meetings

Maybe things have changed in the last 25 years, but if you do decide to do this I would not go to NA meetings. My experience with NA is that alcoholics and pot smokers are not taken very seriously. I'm more than happy to be corrected on this point, but this is the advice I would give my closest friends.
posted by Room 641-A at 6:59 PM on May 29, 2014

Among several reasons AA was't a good fit for me is the rules of the groups I experienced did not permit discussion between participants during meetings, so the sessions boiled down to a series of monologues that might or might not be related to one another. In the meetings I attended, people didn't offer opinions about what other people had said, and it was against the rules to offer advice.

So the AA meetings I went to were of no help in getting a conversation going about my issues or eliciting people's points of views about my feelings and experiences. Or vice versa.

As for fellowship, I have always had a hard time connecting with others, so the chit-chat before meetings and especially the little clusters of conversation among people who already knew each other actually made me feel isolated rather than part of a fellowship.
posted by ADave at 10:16 PM on May 29, 2014

It's fine to hang out at AA meetings without being all over the sobriety thing. You know a lot of the people who go there do so because it's court-mandated, right? And "fake it till you make it" and all that? Well, it's fine to go check it out in your case, too.

Then two other things that popped out from your question. One, the only thing that gives me pause about your narrative is how you describe your relationship to drinking. You say it was destructive, prevalent, and that you relate to a lot of alcoholic stories, but then you also say that it'd be fine with you if you started drinking again. On the face of it that seems contradictory. Two, if I was seeing a therapist who called me "emotionally stunted" I think I'd quit them and find another therapist. I know there are a lot of different schools of therapy but between the "stunted" and the refusing to talk about stuff until you're in AA, it sounds like she's manhandling you a little bit, and that wouldn't be cool with me.
posted by sockanalia at 4:06 AM on May 30, 2014

Response by poster: Too much gold in the responses to pick a best answer. Some of my thoughts, for anyone still playing: What Anna said about her clinical boundaries was confusing to me, too. She used that phrase at the top of the hour of our second-to-last session. I sat down to session and opened by telling her that I’d been feeling tremendous shame for two days because for two nights I had nightmares about getting wasted and embarrassing myself publicly before loved ones. She called these dreams “drunk dreams” and said that, while she is a drug and alcohol counselor, she’s not my drug or alcohol counselor; she’s my Mind-Body Therapist and the therapeutic relationship is different, so let’s not discuss it. We went on to talk about establishing more supports (as commenters noted. Supports are necessary in life…), but for the entirety of that session, as well as the next session I had, I was more confused than anything as she and I talked about boundaries and about how everything out of my mouth was in breach of her boundaries. I felt interrupted. I felt conversations were derailed by pedantry. I felt I was making semantic errors and they became a big deal. (I used the word “suggestion” to replace “recommendation” and apparently there’s a huge distinction between the two. She is NOT suggesting I go to AA! She is recommending it, get it right. I used the word Counsellor. She stopped me short to defend her title as Mind-Body Therapist. I told her I liked the new magazines she was displaying. She said she doesn’t like them, just being honest. They’re garbage. And on and on. )

There’s clearly a disconnect, but as a dry drunk, I’m totally unsure of my perceptions, and feel totally out of touch with any feelings. All I’m doing is thinking and thinking—Maybe I’m Doing Therapy Wrong, etc. Maybe my ego is getting in the way—

spunweb’s answer made me forget I was reading, and my world went still. Thank you for some hard science. jaguar, that Anna recommended AA to me indeed seems to indicate she’s not all bad, in spite of the aforementioned weirdness. Thank you very much for your thoughts.

The personal anecdotes touched me. The encouragement is so very sweet.

My relationship with alcohol (sockanalia) is I can’t see how having a drink will ever sound like a good idea to me, but who knows if I might decide a glass of sherry is my thing when I’m 80 years old. Like I said, there’s zero temptation to drink right now, but I have a hard time saying Never. It just seems naïve to think I’ve got Future Me all figured out.

Special nod to BibiRose. Big hugs to ever last one of ya. Thanks. Maybe I’ll follow up in 30
posted by little_dog_laughing at 8:02 AM on May 30, 2014 [3 favorites]

Anna sounds like she's gone off in the weeds, frankly. I don't see how you could work productively with a therapist who is constantly gainsaying you. It seems like she is making you feel worse about yourself without giving you techniques or guidance for progressing. Find someone better suited to you.
posted by Johnny Wallflower at 9:50 AM on May 30, 2014 [5 favorites]

Your follow-up tilts me more firmly away from your therapist than your initial question did. She sounds like she's being difficult for the sake of being difficult.

What training, credentials, and licensing does she have as a "Mind-Body Therapist"? I'm wondering if you need someone with a more comprehensive scope of practice and licensing. There are many LCSWs (licensed clinical social workers), MFTs (marriage & family therapists), LPCs (licensed professional counselors), and psychologists who incorporate mind-body work without getting all huffy about titles, and who can enforce boundaries in more loving ways.

I stand behind everything I said about why AA might be an appropriate resource for you, but I totally take back everything I said about giving Anna the benefit of the doubt at this point. It sounds like she's trying to force your problems into her framework rather than trying to help you get the actual help you might need at this point.
posted by jaguar at 11:04 AM on May 30, 2014 [2 favorites]

I sat down to session and opened by telling her that I’d been feeling tremendous shame for two days because for two nights I had nightmares about getting wasted and embarrassing myself publicly before loved ones.

Dreams are typically symbolic, not literal. This most likely has absolutely nothing to do with actually drinking and more to do with the personal meaning of those experiences or it is some kind of play on words. In other words, it is more likely that says something like (play on words version): "I fear I am wasting my life and this makes me an embarrassment to my loved ones." or (symbolic meaning) it indicates that you currently have some experience that makes you feel much like you once felt when you used to get really drunk and then had regrets about it.

Those types of meanings are much, much more likely than the literal concern about drinking. Dreams just don't tend to be literal.
posted by Michele in California at 11:07 AM on May 30, 2014

Yeah, if your nightmares are 'drunk dreams', then what the hell are all the nightmares in which I've been smoking again? (Quitting date: June 6th 1989.) It's a genre of anxiety dream, just like dreams about falling or wardrobe malfunctions.
posted by feral_goldfish at 1:13 PM on May 30, 2014

Almost everyone I know who quit drinking has talked about having them. I had one the other night (I quit drinking about 2.5 years ago). I have seen people be really bothered by them, like it means something is shallow or wrong with their recovery. They can be very upsetting. I counsel people (including myself) to not be very concerned about them, or at least not to get obsessed with them. Some people consider them to be beneficial, in that they let you play out relapsing in the dream world, and feel like shit about it, and then you get to wake up and actually not do it.
posted by thelonius at 8:25 PM on May 30, 2014

Response by poster: Here's my update a month later: I left the therapist and have not attended any more AA meetings. I'm very happy with my decisions. Things are going very well for me at the moment. If you have somebody stressing you out with their negativity, my god it feels good to rid yourself of them.
posted by little_dog_laughing at 2:24 PM on July 1, 2014 [4 favorites]

Awesome. You sound like you're on a good path; best wishes!
posted by Johnny Wallflower at 8:57 PM on July 1, 2014

Yay!! Best of luck!
posted by spunweb at 8:51 PM on July 5, 2014

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