Although this exercise will likely stir up powerful emotions, its primary purpose is to show patients the importance of grief anniversaries and the role they play in potential relapse or harm to themselves. I believe it’s better for patients to encounter these internal calendar dates while in treatment than to encounter them later, by themselves.

On several occasions, I have seen patients become “blindsided” or distraught to the point that they needed to leave the lecture hall and sit by themselves or with another therapist as a result of this exercise. Therefore, it is important to understand its impact and to have a secondary therapist on hand to attend to those who are suddenly overcome by acute grief.

The background
As a recovering alcoholic since 1982, I remember well a “sponsee” who called me in crisis one evening several years ago from the transitional facility where he was staying. “Bill” (a pseudonym) had been making progress — attending 12-Step meetings, verbalizing significant insights associated with his drinking problems — and appeared to be working toward full recovery. When I arrived at the facility, Bill told me about his horrible day. He awoke in a foul mood, refusing to speak to anyone, not wanting to leave his room, where he spent most of the day crying. Bill became so distraught and consumed with grief that he began to speak of his recovery in terms of hopelessness.

Perplexed, I actively listened to him and tried to determine what had caused the sudden regression in his recovery. I suggested a full battery of psychological tests and considered calling a psychologist or psychotherapist. Then, a thought crossed my mind, and I said, “Bill, today is October 24th. Does this date mean anything to you?”

“Oh, my God; today is the second anniversary of my brother’s suicide,” he said.
As we processed this, Bill came to realize that subconsciously he knew this but consciously was unaware. We spoke of his brother and what he meant to Bill, and he grieved the loss. When we parted for the night, he reflected on how his failure to anticipate this important internal calendar date had nearly derailed his recovery.

The lecture
As addiction professionals, we are familiar with the special calendar days that are tough on those who are new to recovery. When these external calendar days come around — Thanksgiving, Christmas, New Year’s Eve — a good therapist will spend a lot of time discussing them, especially in outpatient treatment centers. External calendar dates tend to produce a great deal of stress and often are associated with drinking or depression. Also, they are universal, or shared by others in the recovering community. These dates are conscious dates; we know they’re coming (most often they are announced ad nauseam in the broadcast and print media). But even through we know they are coming, people who are new to recovery aren’t always prepared for them and, as a result, may relapse.

As external calendar dates approach, a good therapist will spend group process time to ensure that everyone is prepared. They don’t want to hear a patient say, “Yes, I plan to sleep late on Christmas Day, get up, and then hang with buddies all day.” That’s not a plan; or at least not a therapeutic plan. Rather, therapists should encourage a plan where a patient says, “I’m going to get up on Christmas Day, attend my support group, and then go to my sponsor’s house where we’ll all celebrate Christmas in a setting that avoids the pressure to drink and drug.”

Everyone is aware of these external calendar days, including Super Bowl Sunday, Valentine’s Day, St. Patrick’s Day, Mother’s Day, Father’s Day, Fourth of July, Thanksgiving, Christmas, and, certainly, New Year’s Eve. This list can even further be expanded to include our personal birthdays, the founding date of the U.S. Marine Corps, and the pseudo Mexican holiday of Cinco de Mayo, known throughout the Southwest as “Cinco de Drink-o.”

No one is surprised to find holidays such as New Year’s Eve and the Fourth of July on this list. It’s a time-honored tradition to make some noise on these festive occasions. And what better way to make some noise than to toss back a few drinks beforehand? You certainly can’t watch a Super Bowl game without beer — and if we fail to think of suds on this occasion, our televisions will remind us, with images of beautiful, young, happy people in well-lit bars, tossing back glass after glass, seemingly without impairment or consequence. St. Patrick’s Day is so beer-soaked that it must pain many Irish to realize that their one great day of the year has somehow morphed into a national day of drunkenness and misery.

You may be surprised to find Valentine’s Day and Mother’s Day on the same list as New Year’s Eve until you remember that all of us view dozens of television commercials during these special occasions that show clean, happy couples and smiling families presenting gifts. Many of our patients will view these lovely idealized scenes as depressing reminders that their own families are long gone, or that their children are residing in foster care. Or perhaps they will be reminded that they have long been without a significant life partner and have no expectation of having one in the near future.

It’s up to each patient to anticipate these external holidays and ensure, with the help of a treatment facility or a 12-Step sponsor, that they protect themselves by doubling up on their support group attendance and taking precautions to be in a “slippery free” environment that’s free of slippery people.

Internal calendar days
Yet, experiences with Bill, and others like him, have shown me that in addition to these external calendar days, there exist what I call internal calendar days. These are treacherous, often self-sabotaging days that all of us have but don’t tell anyone about until it’s too late. These are subconscious days, unique to each particular patient. These days may include traumatic events such as, the death of a loved one, or the date on which a child is given up for adoption or placed in court custody, the date a divorce was finalized, or the date on which a person relapsed and adopted a new sobriety date.

Of course, internal calendar dates can be very pleasant — a marriage anniversary, children’s birthdays, or the day one got off probation, for example. But make no mistake; until therapists actually have a vehicle for exposing these internal calendar days, they will remain coiled likes snakes, ever ready to strike those who are working toward recovery.

The way I have learned to approach this lecture is to speak for about 20 minutes on shared stressful dates - the external calendar dates. Then, I explain the importance of recognizing the list of internal days unique to each of us. After giving clients 10 minutes to ponder their own internal calendar dates, I have them write the dates on a dry-erase board and explain to the group why they are significant. It usually looks something like this:
• March 21 — is the day my husband left me.
• June 8 — is the day CPS took my kids away.
• September 6 — is the day my mom abandoned our family.
• December 4 — is the day I was shocked to find out I was adopted.

Obviously, this kind of exercise produces plenty of emotion, and it’s good to be prepared for a heavy session by inviting another therapist to become involved. Don’t be surprised if patient after patient troops to the board, writes their list, and weeps for a few minutes.

Again, the goal of uncovering and anticipating internal calendar dates is not to generate so much anxiety over each one that recovery is sabotaged. It is for each patient to recognize or anticipate his or her personal calendar days while still in treatment; respect these dates; share them with their sponsor or therapist; plan for them; and essentially, surround themselves with safe people once the day arrives.

Recognizing grief anniversaries
Becoming familiar with the idea that each patient presents with his or her own internal calendar dates should decrease your facility’s rate of relapse and explain why many of your patients suddenly leave treatment AMA. It could become a regular lecture in your Relapse Prevention curriculum.

I know a City of Phoenix employee assistance person who, each year on the anniversary of a fatal workplace shooting that happened in the early 1990s at City Hall, holds an “anniversary event.” This is not meant to perpetuate grief or retraumatize survivors; it is mean to process what happened, to acknowledge the mutual grief, and to come together as a grieving community.

Ken Lucas is a licensed substance abuse therapist and is the Arizona community relations director for Valley Hope Association. He is the author of Outwitting Your Alcoholic (Idyll Arbor Press); his newest book is The Reality Between: A Buddhist Approach to Addiction, Grief, and Psychotherapy. He can be reached at kenlucasbooks.com.

This article is published in Counselor,The Magazine for Addiction Professionals, August 2005, v.6, n.4, pp.38-39.

---

Comments

Add New Search RSS

Write comment
Name:
Email:	do not notifynotify
Title:
UBBCode:	-color-aquablackbluefuchsiagraygreenlimemaroonnavyolivepurpleredsilvertealwhiteyellow -size-tinysmallmediumlargehuge
	Please input the anti-spam code that you can read in the image.

Powered by !JoomlaComment 3.25

3.25 Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."