As a youth, I can vividly remember watching my father solve the daily cryptoquotes in our local newspaper. I was confounded by the coded letter-word puzzles. Little did I know that I would find the patience and perseverance to be able to crack the codes myself as an adult. Then, just this past year, the real reason I engaged in the mental gymnastics of it became apparent. Reading the solutions out loud to my partner, Karen, it became obvious that the quotes have utility beyond my personal bragging rights and linguistic acuity. I could use them and recommend others to use them. Some of the phrases can serve as inspiration for the group counseling sessions, that we facilitate. A cryptoquote solution attributed to inspirational speaker and author Angelou has a take on change, action and acceptance, which reminds me of the 12-step philosophy on the matter: “If you don’t like something, change it. If you can’t change it, change your attitude.”

Prior to fully recognizing the selfish nature I often exhibited in adulthood, I unconsciously operated under the axiom, “If there isn’t anything in it for Tom, Tom isn’t in it.” And as I look back, I was very good at sizing up a situation in a nanosecond. This behavior often described my need for material things, but I believe there is also an emotional component to selfishness. In my case I have come to see both as an expression of insecurity and need for validation. The latter can be summed up by the dating scenario, during which one person dominates the conversation—sharing in glowing terms his/her attributes and outstanding contributions to society. After waxing narcisstically through the appetizers and while working over a two-pound lobster, she/he declares, “Enough about me, what do you think of me?”

In a similar vein, perhaps you’ve heard active addiction described as the ultimate expression of selfishness. The physiological aspects of addiction predominantly drive this selfishness. But absent active addiction, selfishness often does not initially get transformed because it is unconsciously perceived as a survival mechanism. The AA Big Book authors summed up the nature and gravity of ongoing selfishness in recovery:

Selfishness—self centeredness! That we think is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking and self pity, we step on the toes of our fellows and they retaliate … Above everything else we alcoholics must be rid of this selfishness. —Alcoholics Anonymous

The analogy above may explain,in part, why teens and young adults often find attendance of Alcoholic’s Anonymous (AA) and Narcotic’s Anonymous (NA) meetings intellectually challenging, if not socially intolerable. The average age of persons attending AA is 48 (aa.org), and Certified Brain Injury Specialist Peter E. Gergler says teens perceiving themselves as, “being 50-feet tall and bullet proof doesn’t help” bridge the generational gap.

If you aspire to be a so-called “strengths-based counselor,” a good starting point is striving to instill hope by helping clients identify, build upon and expand assets. Developing and refining life skills, relapse prevention tools and professional competence are also keys to moving forward in one’s recovery. Some mouths are agape after I tell clients that, looking out at them, I don’t see “addicts and alcoholics,” or persons diagnosed with bipolar disorder, ADHD, schizophrenia or major depression. I see intelligent, articulate, creative and courageous individuals who have the desire and opportunity to embrace recovery. With this as the backdrop of collaborating with our clients to alter the course and quality of their lives, they come to believe that they can leave behind their active addiction and move forward in recovery with confidence and a positive outlook.

What’s the one thing you would change about a past experience, or consequence of a decision made, while under the influence of a mind-altering substance? No doubt this is an interesting question to ponder; but what does it have to do with the early recovery efforts of the persons with whom we work? Actually, everything. Letting go of the past—assimilating its lessons in order to change attitudes and build healthy decision patterns—is the heart of recovery. It’s what we do. Indeed, dealing with regrets and taking responsibility for past actions is the essential work of steps four and five of the 12 steps of Alcoholics Anonymous. Every­thing in the afterlife of a client hinges on identifying and clearing away, as much as possible, the consequences of regrettable actions. One of the great scientific minds of our time, Albert Einstein, weighed in on the matter of past, present and future this way: “Learn from yesterday, live for today, hope for tomorrow.”

The Amazing, Memorable, “Addiction is the feces that stinks. Recovery is the garden that smells good.” A man participating in a treatment group I facilitated spoke these words, which he used to contrast his experience with the disease of addiction and wellness. Words have the power to clarify, heal and inspire. Often clients have provided me with proverbial linguistic gems: “Any (wo)man who evades his destiny will be uneasy in his conscience”; “I don’t want to change my behaviors, I just want to ignore them”; “In the Navy drinking is encouraged, drunkenness is frowned upon.”

We serve our clients well when remembering the cognitive deficits that frequently plague those fresh out of a stint in detox. In fact, the founders and early pioneers of Alcoholics Anonymous (AA) now seem prescient in their brilliance when they came up with those pithy suggested words by which to live life in early recovery and beyond. My sponsor was a big proponent of the phrases of AA. John was 31-years sober when he died two years ago after suffering a heart attack while volunteering for a non-profit agency.

He frequently told me that when he first started attending AA meetings, about all he could comprehend in his alcohol-addled brain were the mainstays of early AA philosophy: Keep it Simple; This Too Shall Pass; Easy Does It; Think, Think, Think; Live and Let Live; and One Day at a Time. AA trailblazers had the wisdom to put these phrases on placards, which found their way on to church hall tables and other meeting venues worldwide. The axioms don’t seem to be as ubiquitous as I imagine they were back in the early days of AA. I miss John for his caring sobriety mentorship and overall encouragement. When I came to him with a life challenge, which I often did, his response invariably would end with, “It isn’t easy Magoo.” It hasn’t been easy to cope with the void his passing created. In the spirit of John’s dedication to living out the AA philosophy of one member of the fellowship helping another, I offer some additional amazing, memorable, profound, intellectually transformative, unique and pithy quotes (AMP IT UP!) I’ve heard during the course of my life and especially during my 11-year counseling career: Believe; If not now, when?; The elevator to sobriety is broken, you’ll have to take the steps; Smile the Spirit; I’m only limited by my self-limiting thoughts; They are all victories, some are just larger than others; Good things happen to good people, and you’re good people; It is what it is, or is it?; If you aren’t having fun, why are you doing it?

To help clients surface their own thought provoking and inspiring words, I’ve conducted “Daily Guidance” groups. The practice was a staple of the Oxford Group and detailed in the pamphlet “How to Listen to God,” written by Reverend John Batterson.
(Unpublished, n.d.) Historian Wally Paton thoroughly describes the process in a book with the same title, while profiling James Houck. Until his death at 100 in 2006, Houck was the last living link between the Oxford Group and AA co-founder, Bill Wilson. Wilson is said to have borrowed heavily from the tenets of the Oxford Group, while writing the still relevant book on addiction and recovery, “Alcoholics Anonymous” (Alcoholics Anonymous World Services, Inc. New York 4th edition, 2001).

Do you hear what I hear?   
I understand that my most meaningful life’s work has been “Assisting others in healing and growth,” while allowing them to recover not on any timetable other than the one to which they are willing to commit. My first graduate school internship yielded another phrase for me to ponder and embrace: “What we resist will persist. And when we resist change, we resist the essence of life” in recovery. Notice the “we” word, which reminds me that, “I get drunk and we stay sober.”

Surely one of our challenges as clinicians is to engage clients and encourage them about having an ongoing dialogue with others, which can ultimately create a space where it’s safe to be vulnerable. It is often in this space of vulnerability wherein clients can more fully view those issues that historically have led to relapse.

Participating in a 2001 seminar co-facilitated by James Houk, he related that when he chose to make an amends to another, that person often chose to share something personal about them. I found this to be true in my own early recovery. Whether it was on planes, trains or in taxis, I was eager to discuss life in general. Invariably I would bring closure to the conversation with words of appreciation: “Thank you for allowing me to share my heart with you and thank you for choosing to share your heart with me.”

Life is grand and the smell of the garden of recovery is good!

Thomas M. Greaney, MEd, LADC, LCDP, provides his private practice clients in CT and RI with creative ways to view and over­come addiction. He facilitates groups for 18-24-year-olds at an agency in southern CT. Tom presents seminars on creative approaches to group therapy. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 860-912-2944.

“There is no difference between an inappropriate orgasm and a recovered alcoholic taking a drink.” —“Gerard,” 45, sober 10 years.

“We (sex addicts) detox too. We are addicted to the endorphins. Our withdrawal is pretty intense.” —“Sharon,” 37, member of Sex Addicts Anonymous, sober six-and-a-half years.

“Desire, at the end, was a malady, or a madness, or both . . . .I ceased to be Lord over myself. I was no longer the Captain of my Soul.”
—Playwright Oscar Wilde

Thanks to the headline grabbing falls from grace of a golf icon and late night TV host, sex addiction is the new/old frontier in 12 Step recovery. Some see sex addiction as the diagnosis du jour for men behaving badly. But long before Tiger Woods and David Letterman, the quintessential sex addict was famed lothario Casanova. To this day a serial seducer is known as a “real Casanova.”

Behind such “success” is a compulsion that destroys marriages, embarrasses and horrifies adult children and results in the transmission of diseases. Like addiction to alcohol and other drugs, sex addiction is an equal opportunity destroyer.

Tracing the roots
As with many addictions, sex addiction is often rooted in childhood trauma. In interviews with three self-proclaimed male and two female sex addicts, patterns of dysfunction and trauma emerged. The males range in age from 17 to 57. A priest sexually abused the eldest and another said he switched addictions from alcohol and cocaine. The teen said he couldn’t resist the advances of girls seeking sex via sexting—the sending of X-rated photos via cell phones and raunchy phone calls. The women felt their sex addiction made them bad persons. So desperate was “Faith” that she “took a razor blade and etched the sign of a cross on my inner thighs, thinking that would stop me from leading this double life.” For each of the five, the pain of addiction led to confusion, self-loathing and lives that spiraled out of control.  

“It’s about core issues, about pain. Tiger’s addiction probably has something to do with his father and pain that he never dealt with. I read that his dad had multiple affairs,” said Marshall Lipscomb, who has gone public with his sex addiction. Lipscomb expressed this insight: “What would trigger it (sex with strangers) was anger, loneliness, fear of failure, unworthiness, unstructured free time, fear of rejection … It would temporarily make my negative thoughts and feelings go away” (Merli, 2010).

“Gerard” said he pursued sex with prostitutes “not because it felt so good and I enjoyed it so much but because I had to have it. It was a part of me I could not surrender to God.”

“Sharon,” a 37-year-old business owner, said her husband finding graphic e-mails she had written to her lovers precipitated her bottom. Her embarrassment was exponentially exacerbated when he shared the “damning evidence” with her family. She traced the roots of her addiction to self-esteem. “I had an enormous ego and it was fragile,” she said. “My whole life drive was to keep it inflated and keep it from being harmed.”
While in treatment “Sharon” was put on a “no male contact contract, which was so hard for me.” She wore a “NO MALES” placard around her neck. In response she fantasized about flirting with the barista at Starbucks to get a free cappuccino. “My whole identity was talking to men, flirting with men,” she added.

Assessing the cost
Sex addiction treatment often costs more than inpatient programs for other dependencies, but the emotional, mental and spiritual devastation of sex addiction exacts a cost that can’t be calculated.

Sex addiction terminology and treatment has grown widely since Patrick Carnes coined the phrase in the late 1970s. According to Carnes, sex addiction often co-occurs with alcohol dependence, and it is a fallacy to assume that recovery from alcohol dependence will resolve sex addiction (Scott, 1988).

The role of creativity in recovery
Creative approaches in treatment are often key to long-term recovery and an improved quality of life. “Faith” said expressing her feelings via role-playing and journaling helped her deal with being emotionally shut down and codependent. Art therapy also played a critical role in Faith’s recovery, and she noted that although she initially perceived disturbing sexual images in her drawings, these were eventually replaced with more positive images. In her first year of recovery Faith drew nearly every day; she now uses the soothing, modern-day personal Rorschach exercise 15 times a year.

Saddled with PTSD from repeated childhood sexual abuse of forced oral sex on her father, Faith reported a disturbing flashback this year. While at the dentist she was given a numbing agent for a procedure. She said that “goop going down my throat” made her want to jump out of the chair and flee the office but, “I didn’t do anything, I was frozen and later cried ­hysterically.”

“Gerard” voiced the unresolved anger and self-loathing felt by many sex addicts. “God is not doing what I want Him to do to help me resolve this addiction and sometimes I’m pissed off by it,” he said. Gerard’s predilection is oral sex procured from prostitutes. “I’m 10 years sober from alcohol and cocaine and I don’t have a mate,” he said. “If I can’t find a mate, screw it, I’m just going to go out and buy one.” He referred to his sexual pursuits as a compulsion, one that “synthetically fills that sexual part of me.” “Gerard” said sex with prostitutes, some of whom he tried to help get sober, led to him contracting herpes 20 years ago. He said he is giving his sex addiction to God because his life is “unmanageable” and preventing him from finding the “right woman” he so desperately seeks.

Recovery’s fulfillment
The redemption of reclaiming her life from the suffocating embrace of sex addiction is a gift “Faith” gives thanks for every day. Next year she will celebrate 25 years of sobriety. Today “Faith” does not act on sexual compulsions. “I don’t react or go on auto pilot. I have serenity, peace, joy and excitement about life,” she said. “God is calling me to share my story.”

For “Sharon,” ritual and 12 Step recovery were critical elements of getting well. In treatment she created a “chalk” outline of her prone addict on paper. She dressed and burned in effigy the representation of her former self. “She looked like the melting witch in the Wizard of Oz, with her limbs flailing as she curled into the fire,” she said.

“Sharon” reports a “fantastic” sex life with her current husband. “It’s so important to not go from being a sex addict to having a lame sex life, or worse than that to having no sex life,” she said. “That’s a recipe for relapse.”

Thomas M. Greaney, MEd, LADC, CCDP, provides his private practice clients in CT and RI with creative ways to view and overcome addiction. He facilitates groups for 18-24-year-olds at an agency in southern CT. Tom presents seminars on creative approaches to group therapy. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 860-912-2944.

References
Merli, M. (2010). Recovering sex addict hopes openness will help others. The News-Gazette. Champaign, Ill. Feb. 7, 2010.
Scott, N. (1988). Sexual addiction and chemical
dependency: an interview with Patrick Carnes.
Alcoholism & Addiction Magazine. Vol. 9, no, 2. p.45 (3)

Ever wonder what the most important factors might be in sparking and fostering the creativity of adolescent substance abuse clients? My experience working with teens has helped me boil it down to two qualities: encouragement and genuine interest.

I have often been amazed by the creative abilities of adolescent clients, especially in writing about their feelings toward themselves and the disease of addiction. Frequently this column has focused on cultivating our creativity in counseling clients contending with substance abuse issues. It’s equally im­portant to be able to create a safe environment that promotes the originality of those with whom we collaborate in the process of getting well.

Carl Jung, himself a prolific writer and prominent 20th century psychiatrist and friend of Alcoholics Anony­mous, said, “There is something unpredictable about the writing process.” My own experience of nearly 20 years of journaling has time and again led to moments of the WOW and the WHOA. Did those thoughts come from within me or outside of me?

The white paper, Guide for Working With Adolescents, (North Carolina Area Health Education Centers, 1996) suggests that, “Opportunities to express creatively their new feelings, interests, abilities, and thoughts help young adolescents understand and accept the new people they are becoming.” This perhaps is doubly true for youth in early recovery as they try to work through and make sense of trauma, abandonment and how to fit in. An 18-year-old female client captured the struggle and challenge:

I’m trying to get through day by day. Trying to get by sitting, watching the time fly. Trying to get what I need. Trying to learn what needs to be so I can go home and get free from myself, from who I used to be. Because in reality this ain’t the real me. And I’m so sorry.  

Desperation, the Pathway to Hope
Desperation can give way to hope, ironically, when the topic is dealing with one’s anger. For many of us, anger was not appropriately modeled or expressed as the perfectly normal emotion it is. Perhaps as children we witnessed domestic violence, or experienced the emotional trauma of verbal and physical raging. These occurrences may lead one to avoid conflict as an adult or even cower at the perception of a clash.
Giving clients the unfettered opportunity to vent proves cathartic for many as they put pen to paper. Such was the case for a female client who was part of a group engaged in stream of consciousness writing on the topic, “My Anger.”

In her prose she raged against the death of her partner in a no holds barred, written and then verbal barrage, replete with expletives that were not deleted.  The end result? “It was a release for me. I got a lot off my chest, things I didn’t even know I thought about, things that were hidden in the darkness.” Seeing her reddening face and hearing the passionate expressiveness as she spoke, it was if the exercise had become a literary pounding of the ­pillow punctuated by a primal scream.

To bring a lightness to the group, especially since the anger exercise was the last session of the day, I had clients write their reflections on joy. A young man wrote a series of his impressions. “A feeling expressed when happy. A state of mind I long to be in. A chemical reaction created by our brain. A high that can’t be touched. A positive addiction. The need to love.”

The Opposite of “High” Art
Many of my clients are incredible artists and they have graciously allowed me to make copies of their prized works. In a piece I’ve titled “Heroin’s Dance of Death,” 17-year-old Rachel captured the bare bones,haunting and impen­ding death wrought by the ­disease.

A group art exercise also can yield incredible results. One of my intensive outpatient groups was charged with depicting the “face” of addiction. We had the luxury of access to a kitchen so the face was made out of bread but inexpensive paper Mache could work, too. The decade-old bread visage, with its green face, jaundiced eyes, blackened teeth, spotted tongue and devilish horns, lives on as my prop. I use this image with groups who are encouraged to draw their own versions of the daunting disease.   

It’s easy for me to show genuine interest in client work. I display a range of efforts on my office walls and showcase others in my ­column!

Thomas M. Greaney, MEd, LADC, CCDP, provides his private practice clients in CT and RI with creative ways to view and overcome addiction.
He facilitates groups for 18-24-year-olds at an agency in southern CT. Tom presents seminars on creative approaches to group therapy. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 860-912-2944.