today’s post is full of allegory. after the recent passing of a friend. i have come to a sort of secret compartment in my life. i was talking about how strange it was to have known someone on both a professional (counselor to client) level and as a fellow community member and volunteer. this caused me to pause for a while and consider the hidden cost of being an addictions counselor working with lgbt persons with addictions (who may or may not be hiv positive).
it is a complete recurrence that gay men (hiv + and hiv -) will appear when they need support and then disappear when they no longer feel the need for support (for a variety of reasons). as a professional there is an ongoing and undisclosed cost of knowing and caring for a person and then having them leave your life just as quickly as they appeared. and my experience is that when the “gay” factor, and the “hiv +” factor are combined, i have found that the boundaries have been a bit less distinctive. i might have cared a little more, or offered a little more support. and of course the disappearance of these folks from my practice has consistently left a deeper impression. but after they leave the treatment cocoon, they enter back into the community arena along with me and the rest of our world. because these individuals and i have engaged in a therapeutic relationship, returning to a friendly relationship is strained at best. i know more about them than they probably would like to admit. they have shared secrets with me. if they did not complete, nor were successful with treatment, then this usually means they won’t want to see me in person, nor see themselves in my eyes. this is perfectly understandable- almost expected. but it does have a price tag- especially in a smaller community. it is not a deal breaker at all. it is simply that i haven’t really looked at my own real needs in all this.
until this week, i have not looked at my own feelings about this whole brief therapy process. with bryan’s passing, i now understand that it has had a price. i have assumed that my skills as a practitioner are lacking at times. i have felt that i am too blunt for people too early. i have even felt that i am too old at times and out of touch with current lgbt culture.
although all of these are probable and appropriate, i have never considered that i might need some support around the loss this process brings. i now know that i have just hunkered down, trudged forward, cut my losses and tucked those feelings without processing or examining them with any concern. i don’t regret this after realizing this, but i do want to make some changes from here forward. and because of my childhood history of relationship and loss, i have had auto-responses of shutting down when i have become saddened. i have let go of friends because i honestly haven’t figured out yet how to do anything else quite yet.
to be less vague, i now understand that i have a primal feeling that i am not okay, so i assume that these losses are the price i am required to pay for being me-(conversely, there are many benefits to being me as well so i don’t think this as simply dark and morose).
since my work has recently shifted away from cultural specific clients, i have gained some distance and some perspective on all this. this reminds me yet again that situations and experiences in our lives shape, form, and mold who we are. and all the relationships, fabulous jobs, exciting or relaxing vacations, spas, makeovers, workouts, and new clothes in the world won’t really make me any different. i am required to do the work, look at my life and my part in it, feel my feelings, accept them, understand them, and make room for change if needed. and change is probably needed in this case.
i am posting from a quiet place of gratitude today. i hope your holiday brings even a small portion of the grace i feel today. happy thanksgiving.
i first met laura when i was doing advocacy for a small community based organization in aurora named “itav”. laura was a sex worker and smoking a lot of crack. i drove over to her boyfriend’s apartment in west denver and brought her to the agency so she could go to a women’s group, get something to eat, and get away from her life for a minute. i remember very well the conversations we had in the car on the ride to and from.
fast forward to 2 years ago when i ran into her again. she had now become the house manager for a program for plwa’s in athmar park. she had slowed way down on the crack use and had gotten into medical care-even consistently taking haart medication. she was much more grounded and again we talked often and repeatedly about the direction of her life. she was with her boyfriend who was intermittently quite abusive. it appeared he had a mental health issue and refused to take medication reliably. when he would drink alcohol or use cocaine, his mean streak would especially arise and her physical injury rate would escalate.
shortly after i ran into her again, the two of them had a volatile altercation and he picked up a tv and threw it at her, breaking her leg and some of her spirit at the same time. because of her position at the housing program, a police report was filed and chargers were drawn. he ended up spending about 10 months in jail being released sometime late last fall.
naturally, what followed were conversations around self-care and responsibility to the residents under her watch. she started to smoke crack more frequently, smoke pot more frequently, and engage in some other odd behaviors. but she was able to reel in it for the most part. many of the residents that she looked after had their own serious life issues going on and i will never really know if she was able to truly present for them because of her own internal drama. but certainly this is how it is with almost everyone. i somehow always felt that she was lost in a current that taking her somewhere quite a distance from here. but i also understood that she was doing much better than when i first met her, so harm reduction rules the day.
this morning i heard the first report of a small tragic story unfolding in the small neighborhood that she lived and worked. as the day unfolded, it became somewhat clearer that there was just a continuation of this same story. i have been both saddened and numbed most of the day. i wish i could have done more.
the following is from the local paper..
written by kieran nicholson and reprinted from www.thedenverpost.com
well it has certainly been a full week of bruhaha. the wisconsin governor and his blatant attempt to raid the ark, the call to impeach obama over the defense of marriage act, and the images of a very sallow charlie sheen spouting insanity from his hollow-rehab pulpit. sometimes the absurdity of life in sobriety seems more muddled than those drug-infused days gone by. but then there is the blessing of a sober perspective.
after mr. sheen’s interviews, it has become increasingly clearer that he is not simply full of himself and lying through his teeth. in my estimation, this is a thin veneer masking a much more serious illness. his ego is so entwined with some chemical changes that have happened in his brain, that he is driven by some f**ked up impulses and not operating on any logic at all. watching his carcinogenic diatribe was surely like witnessing an execution of a relative through the silence of bullet-proof glass.
what gets lost with all the pundits spouting there sharp criticisms, is that what i really witnessed was the howling of a wild animal in pain. this man has an illness. yes, it sparks really shitty and very toxic behaviors both for himself and those around him, but i glimpsed a suffering soul underneath those behaviors. there is deep pain there and it should have the right to heal. this is the harsh reality of the science of addiction and recovery and it takes a hold on him. i will reserve this idea in my head and my heart for him. his world may have to fall apart even more, before he lets go of his delusions. hopefully this process won’t strip his family of their dignity as well as often can happen. but the wheel of fortune is already in motion. we’ll simply have to wait to see where it lands.
i googled the phrase “the disease of our time” after having heard dr. drew refer to narcotics addiction as such. click here for the result.
disease of our time
this concept has definitely activated my imagination. firstly, on a personal note, i would think of AIDS as being of our time. but upon further inspection, cancer would easily fit this bill. ignorance, denial, technology, pollution, science, as well as many others make great arguments in their own way. but for me, apathy seems to be the winner. i think addiction and AIDS are the personal diseases, but apathy is what leads us to the road where this question lies….your thoughts ?????
“We’re all wired to seek emotional validation. For those who’ve experienced shame-based trauma (and I believe this applies to many of us, not just gay men), the emotional invalidation can lead us to develop unhealthy methods for obtaining the validation we crave.
At the core, it’s the pain of not knowing who you are; I call it “the diminished self.” It’s about not knowing what your passion is in life, not knowing what brings you joy, ultimately not knowing the real you. If you’re living life only to please the people around you, that pain ultimately makes life painfully unlivable. You have to retreat into an addiction to compensate for the pain.
Though substance abuse is a major problem among survivors of shame-based trauma, many other behaviors aimed at alleviating the pain of shame can also become addictions. In clinical terms we call them process addictions. These are destructive behavior patterns linked to sex, gambling, shopping or pornography that people use to experience relief from their suffering. In my book, I talk about how gay men acutely struggle with these issues, but this is not unique to gay men—shame-based trauma impacts every part of our culture and its effects are far-reaching.”
i have spent the new year struggling with being average, imperfect, and even over-reactive- especially at work. sometimes i find validation in questioning the status quo and playing devil’s advocate. not always desirable traits when working in a larger entity.
i continue to find that empathy and caring are needed tools in my trade. and i am repeatedly reminded that i have much to learn when working with others. the pain and the distortion that encase people are complicated and separate from my personal experience. often, counseling is walking blindfolded and i am still learning to use all my senses as i move forward.
someone i had never met before told me they had heard of me- not just from the person who introduced us. he then said – “you’re a rock star”…. i am embarrassed to admit that i am amused at this… partially because i work with a computer program named ROCC. additionally, though, i know that my ego is delighted that someone talks about me- and maybe not in a negative way as i always imagine.
someone confided to me today that they were sexually abused at 3 and removed from the custody of their parents. they lived as a ward of the state for almost 10 years. i am still wrecked from the sheer terror of this tale- let alone surviving it.
in rereading this post, perhaps ADD is my disease of our time…
the first time i heard this song was at a house party in 1975 …. my first gay house party… platform shoes…. shoulder length hair… i think low-rise hip-huggers, too.
Everything’s gonna be all right
Everything’s gonna be all right
the origins of addiction for many people most certainly lie in the concept of comfort. drinking and getting high feels good. it comforts. and it often relieves us from painful or difficult or uncomfortable situations or feelings. just think of how a cocktail or two after a hard days/weeks work can almost seem to wipe some stress away like on a dry erase board. mashed potatoes, mac and cheese, hamburgers and fries, a cold, cold pilsner, a dirt martini up with blue cheese stuffed olives, a short tumbler of grappa after a 4 course dinner on the continent. just a little vicoden for the back pain.
for the majority of people, any of these will simply be another in a long list of things that we allow ourselves to enjoy. but for that small percentage of souls, one of these (or all) are the only options that actually work when it comes to offering comfort. maybe they felt abandoned by one of their parents when they were young, and weren’t able to find balance. or perhaps they were molested while still a child. or maybe their parents had a volatile or violent relationship and internalized that it was because of them. of course there is also the possibility that they were born with a chemical imbalance, or grew up in an environment that fostered depression or a diet that enabled adhd. whatever the situation, for a small percentage of our species, the only self comfort learned by them is the addition of something, food, sex, drink, drug.
so it seems quite easy to follow this logic to the place we all know exists-overuse. this indulgence of comfort slips quietly (or not) into a dependence or addiction. as this occurs, any ability they had to comfort themselves slips into the mists of invisibility.and the chasing of this comfort becomes the order of almost every day. and instead of comfort, it becomes snippets of comfort and trying to comfort and the absence of this comfort is more important than the comfort itself, because the brain and its organic chemical processes have adjusted to accommodate this need.
self-comfort seems to me to be at the heart of the matter. a cup of tea, a burt bacharach album, an old hollywood film, a run in the park, a good nap. these actions, just like journaling, reading, talking with a friend, need to be explored in a new way if self- comfort is to be revived. sounds easy, but if it were, then our comrades with these issues would be able to stop behaviors whenever they wanted. however they can’t. who would lose their job and income if they could intervene? who would get arrested repeatedly if they had the ability to change their life’s course? who would wander the streets at night, sleeping where they could, if they had a choice? who would choose any of these discomforts if they had a choice?
You see, we can’t always be with other people. We can’t always feel safe. What we do need to do is teach ourselves how to deal with our alone time and the thoughts that go on in our heads. How do those thoughts make us feel? Anxious, scared, panicky, nervous, jittery, lonely, sad, depressed? If we don’t figure out how to be alone with ourselves, we are in for a scary trip to the end of our journey…..Susan Thom…. searchwarp.com
Step one you say we need to talk
He walks you say sit down it’s just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left and you stay right
Between the lines of fear and blame
And you begin to wonder why you came
our team has been piecing together some ideas for a newer direction for the hiv positive patients who are (or are struggling with) dealing with substance abuse issues and healthcare adherence lapses. there are several factors which are closely related to many of these individuals challenges. trauma, stigma, depression, aging, sexual dysfunction, isolation, self-esteem, mental health are the first of many to come to mind.
most of the patients i see live below the poverty level. some by design, but most reside in this strata because this is all they know. insurance is not an issue as it is not a choice. luckily in colorado, there is a state program which is designed to give access to healthcare to every coloradan. so much of the basic and intricate healthcare issues and hiv care issues can be met. but honestly, many of these individuals don’t care about healthcare or hiv care. the avoidance of these as well as avoiding as many of their feelings beyond numb creates a perfect environment for drug and alcohol use to morph into abuse almost invisibly- at least to them. it’s quite a different story to the world around them as out of balance seems quite evident.
one thing that seems to be a reality in our city is that a sense of community and camaraderie in the world of alcohol and drugs exists and beckons. the bars- especially gay bars are community oriented and geared towards fun while you use. music, emcees, shows, drag shows, comedy, dancing, are all at our fingertips as we begin to cement our relationship with drugs and alcohol. the concept of fun is interlaced with use and as we all know it does feel good to get high. it’s moderation which becomes the issue, or maybe the lack of it.
so when people are conceptualizing themselves changing their use, or stopping their use, the idea of fun and festivity becomes a major factor. “life will be dull without the party” accompanies a belief that there will never be joy in their lives again if they stop using. seems pretty reasonable to me. felt that way myself actually. and if you think about it, the image of sobriety pales with regard to fun-loving. as a matter of fact, even though i believe that being sober has brought an unbelievable sense of calm and peace to my life, i don’t even think my using friends think of me as being very much fun. conversely, i would imagine they see me as a buzz kill.
anyway, we are trying to put together a visual and approachable set of peers who have gone through the changes involved in giving up drug use and drinking and have become conduits of joy. i know that i am much happier than i was before 9/29/04, and if you sit an chat with me for a while, i think you’ll believe it and feel it, and i know it is true of many, many others too! this is the subliminal message we want to disseminate. i am currently looking to seattle’s strength over speed for some inspiration. that grassroots effort has been in development for a few years and i believe they have affected lives. they mix together men who have stopped using meth with men who are actively using- some of those reformed are involved with 12-step and some are not. this encounter, no doubt, allows people weighing their options to see that life can easily continue successfully without the armor of substance protecting us.
the next offering is a workbook-driven curriculum for meth users that is evidence-based and hails from the Matrix Institute of CA. i worked with a version of it previously when i helped develop a program called the “mile high meth project” for another agency. the matrix has its strengths and weaknesses, but the structure works well and it is designed to engage user’s right brain in order to address the left. coming down off meth creates so much emotionality, that any process that can grab their attention is worth its weight in gold. this is not specifically for gay men. this is much more universal. this is also not poz-only. it’s not as if people discriminate when they are actively using, and i am trusting that same acceptance tendency can bring educational opportunities as well as personal growth and self-acceptance.
this layer will hopefully work as we extend our efforts here beyond gay men. in colorado, poz persons who are not gay men struggle with isolation and stigma even more intensely. there is a small sense if community among these subsets, but it is not cohesive. at least not at our workplace. thus far, we have started a drop in group for the gay poz patients and it seems to be making an imprint. this week heralds its 1-year anniversary, and i believe we have had almost 100 persons through our doors. and our substance treatment numbers for that population have quadrupled with the onset of this effort. and the work continues.
of course, what we are working towards includes helping people find their way to healthcare adherence and retention. the science has been available for some time to keep this virus manageable and undetectable. the costly and debilitating problems that unaddressed hiv infection brings can be greatly minimized by adherence. honestly, i have seen about 15 persons pass this year and most of them would be categorized in the aforementioned. i know that what i am working towards is how to save a life.
keep your fingers crossed… oh… and, can you see my heart smile?
of course the fray are from colorado turf. their stunning debut album seemed to almost usher in the latest indie music boon that we are now in the midst. i heard an interview with lead singer isaac as he talked about visiting a mountainside drug and alcohol recovery camp for youth and was inspired to write these lyrics. appropriate…. local…… lovely..
there was a boy who spent a lot of his time running. he had been running for as long as he could remember. and if you asked, he would be hard pressed to tell you when it really began. he knew that he was different and part of him thought that was special and another part of him viewed himself as revolting. but his libido and his chemical makeup consistently created urges that propelled him forward as a sexually active youth who could be considered deviant.
he left home at 16 because the battle inside was too much to bear feeling isolated and trapped in his suburban existence. just like the lou reed song directed, he had to take a walk on the wild side in order to breathe. he ran to the nearest urban mecca he could find. he had already been scoping it out and knew there were similar vibratory souls around. he was very young, but he didn’t care. he knew that anything that could happen could be no worse than the nothings that continued to happen in his life as it was.
he became a rent boy as it was almost a perfect next step. he had already been sexually active for quite some time and had learned to communicate with men on this level. and getting paid for this activity seemed only too good to be true. as it turned out, it wasn’t that good at all. he found himself being objectified in ways he could never have dreamed, and a return of sadness bubbled up now and again amidst all the drugs, alcohol, and recreational sex that averted much of his attention.
a symptom of youth for him was perhaps that he so often got what he wanted. sadly though, this synchronicity was heavily low lighted by his constantly numbed demeanor and his inability to think even slightly big. or maybe it was that he had switched on survival mode early on and hadn’t had the where-with-all to get beyond instinct. it seemed he was bright, but not really smart. and he was hurt, but never really cried. and he barrelled through this part of his teens just like he was endlessly running with his head tucked and his arm out trying to find the goal.
he would pick up tricks for money now and again for the first coupla years he arrived. and he made himself available for free fun, too. on more than one occasion he emerged from situations which chipped away at his naivete and his sense of wonder. he was used, he was abused, he was ridden hard, and he was discarded quickly. he didn’t lose hope. because this myriad of abrasion he lost himself in, felt somehow deserved and familiar. he had hated and hidden so much of his nature, that by this stage of the game, he was conditioned to expect very little to actually put in his pocket. by the same token, he had no reason to think that life would not continue to reveal opportunities. he developed a deeper sense that he had little or no real value, and as long as he could numb, he could continue,,,, really….. no problem. at least not yet.
experience and self-worth are strange things. they link in ways that we rarely suppose. and the path we choose to survive our pain often defines life’s challenges as our road is mapped out and paved. this is a truth for this boy. assumptions and conclusion made during these formative years still tend to line the birdcage of his soul. lined with the discarded copies of his chemical romance.