DB PSYC 620

Preventing Relapse in a Twelve Step Program of Recovery (Part 1 of 2)

1: Introduction

0 seconds DR. G. ALAN MARLATT

[00:00] DR. G. ALAN MARLATTHey, Larry. LARRY: How are you doing? DR. G. ALAN MARLATT: Very good. Good to see you again. LARRY: Okay. Good to see you too.

5 seconds DR. G. ALAN MARLATT

[00:05] DR. G. ALAN MARLATTYeah. So it has been a few weeks since you talked and of course last time you told me about the whole background of...(crosstalk) LARRY: Right. DR. G. ALAN MARLATT: Some of the problems that you were having and the fact that you’ve now been, as you were just saying, seven years this coming...(crosstalk) LARRY: This coming November. DR. G. ALAN MARLATT: Yeah, so it’s June now, so it’s pretty close. LARRY: Yes. It’s

30 seconds LARRY

[00:30] LARRYa pretty important date for me because it’s my birthday also. DR. G. ALAN MARLATT: Yeah.

35 seconds DR. G. ALAN MARLATT

[00:35] DR. G. ALAN MARLATTYou’ve given yourself a huge birthday gift. LARRY: Yes.

40 seconds LARRY

[00:40] LARRYSomething had to change. I used to celebrate my birthdays traditionally without other things, you know. DR. G. ALAN MARLATT: You have given yourself little birthday present gifts but they were,

55 seconds DR. G. ALAN MARLATT

[00:55] DR. G. ALAN MARLATTnot things that weren’t particularly good for you. LARRY: Exactly. DR. G. ALAN MARLATT: So now your gift was taking them away. LARRY: Something had to

1 minute 5 seconds LARRY

[01:05] LARRYchange. DR. G. ALAN MARLATT: Yeah. Well, since we last have been together

2: Discussing Recovery

1 minute 10 seconds DR. G. ALAN MARLATT

[01:10] DR. G. ALAN MARLATThas anything been going on that I should know about? LARRY: Well, actually

1 minute 15 seconds LARRY

[01:15] LARRY, just living life on life’s terms and I got off into some volunteer services, you know, as far as giving back, trying to help others who are struggling in their recovery, you know, introducing them to a new way of life, chairing some meetings. In fact, I chaired one at a shelter, you know, for the homeless. DR. G. ALAN MARLATT: Oh really. LARRY: Right and we meet every Tuesday and Thursday and now we have an AA group meeting, you know, and this has been working pretty good, you know. DR. G. ALAN MARLATT: So your

2 minutes 5 seconds DR. G. ALAN MARLATT

[02:05] DR. G. ALAN MARLATTjob there is a kind of like lead those kind of meetings down or? LARRY: Yeah. I’m the chairperson

2 minutes 15 seconds LARRY

[02:15] LARRYand along with that, you know, there’s a certain amount of responsibility that goes along with that, you know. I remember early on in my recovery, you know, when I used to frequent the shelters, there were people in recovery, well established recoveries to come out and chair meeting and I participated in some of the meeting, so I thought I would try to give back, the way somebody gave to me, you know, when I was going through my struggles, so it’s is pretty good for them and it’s pretty good for me. DR. G. ALAN MARLATT: Yeah, I bet it works both ways that way. LARRY: Absolutely, absolutely. You know, it keeps me fresh. I can visualize and see that anytime I decide to go back to that lifestyle, this is the result or the end result of it, you know, I could lose not only my sobriety, but peace of mind and roof. The lists goes on and on. DR. G. ALAN MARLATT: So working with them, that

3 minutes 35 seconds DR. G. ALAN MARLATT

[03:35] DR. G. ALAN MARLATThelps you kind of be aware and reminds you of what it could otherwise be like. LARRY: Absolutely. It keeps it fresh. I have to say this, because I have

3 minutes 45 seconds LARRY

[03:45] LARRYoften seen it happen. A lot of times people who come into recovery, you know, they have been struggling with drug addiction and alcoholism and they get into the 12-step program and accumulate some sober clean time, you know, a month, a month leads into years, and you cannot put what it was like on the back burner, you know, you try to remove yourself from that history and you don’t try to associate yourself with that, you know, you have a tendency to forget like what it actually used to be like...(crosstalk)

4 minutes 35 seconds DR. G. ALAN MARLATT

[04:35] DR. G. ALAN MARLATTOkay. LARRY: And as a result of that, you know, you basically

4 minutes 40 seconds LARRY

[04:40] LARRYthink you chew it...(crosstalk)

4 minutes 45 seconds DR. G. ALAN MARLATT

[04:45] DR. G. ALAN MARLATTOkay. LARRY: And then you begin to justify,

4 minutes 50 seconds LARRY

[04:50] LARRYminimize, rationalize, having another drink, you know, say well, I have accumulated this, so I’m going go and reward myself. DR. G. ALAN MARLATT: Okay. I have been doing so well, I deserve a drink, right? LARRY: And then a the vicious cycle begins all over again, you know. DR. G. ALAN MARLATT: Yeah. LARRY: This way, when you participate in giving back and chairing meetings and physically right there, dealing with people, you know, you visualize it, you see it, you’re working without this and the literature states, you know, you have to give it way in order to keep it. DR. G. ALAN MARLATT: So people that are having these kinds of problems remind you

5 minutes 40 seconds DR. G. ALAN MARLATT

[05:40] DR. G. ALAN MARLATTor people that are doing what you are doing about, what it was like, so you don’t get thinking unfeared and...(crosstalk) LARRY: Yea, I’m above all that. DR. G. ALAN MARLATT: I’m above all that, right, keeps you still in the whole flow of it, in a way then. LARRY: I think

5 minutes 55 seconds LARRY

[05:55] LARRYwhat it does, in simpler terms, it keeps you grounded, you know, you can get puffed up, you know because you can accumulate a lot of monetary gains and success in certain areas, you know...(crosstalk) DR. G. ALAN MARLATT: Yeah. LARRY: And you begin to think you’re above things, you know, that this affliction or addiction doesn’t pertain you, because you have accumulated this, you may go further in school and achieve an associate’s or master’s, or so, you know, and I’m just giving an example...(crosstalk)

6 minutes 35 seconds DR. G. ALAN MARLATT

[06:35] DR. G. ALAN MARLATTSure. LARRY: Or fortunate to start marketing, hit it big or something, you know

6 minutes 40 seconds LARRY

[06:40] LARRYcome into a windfall of money...(crosstalk) DR. G. ALAN MARLATT: Yeah. LARRY: And lot of people seem to think that money, monetary gain is the cure all and it’s not and it’s really, really nice. DR. G. ALAN MARLATT: Right, because once you have the money in your

6 minutes 55 seconds DR. G. ALAN MARLATT

[06:55] DR. G. ALAN MARLATThand, I mean in a way it’s a whole new...(crosstalk). LARRY: You got a still deal with manageability. DR. G. ALAN MARLATT: Manageability.

7 minutes 0 seconds LARRY

[07:00] LARRYRight, right and a lot of money is a sort of temptation, you know, you can achieve certain things, you can take risks, you know, that you normally would not take if you was living on a budget or certain money income. DR. G. ALAN MARLATT: Sure. So,

7 minutes 25 seconds DR. G. ALAN MARLATT

[07:25] DR. G. ALAN MARLATTin terms of you been doing very well, do you tell these other folks how you handles some of these, what would be triggers, for relapse for other people? LARRY: Oh, absolutely, absolutely. Because

7 minutes 40 seconds LARRY

[07:40] LARRYI can remember I used the terminology that if you shot 24 years ago, but actually it has been a few years ago, you know, and I try to express to them, going in and out of different treatment facilities before it really began to internalize...(crosstalk) DR. G. ALAN MARLATT: Okay.

8 minutes 5 seconds LARRY

[08:05] LARRYYou know, the arrogance of it, you know, become, what you call, street wise and literature wise, knowing all the clichés, the different slogans, you know, the literature, you know, as far as recovery goes, you know, and you could spout it out, but you’re really not living it, you know, really hasn’t internalized, kind of faking the fall. DR. G. ALAN MARLATT: Playing the game but you’re hardly there, right? LARRY: Exactly and it is really important. I don’t know what it is about human culture, but it’s really important for us to feel needed, wanted, or accepted and then we have this image re think where we try to compete amongst each other and if we achieve certain goals, we want to share ‘em, we want to go show it off...(crosstalk) DR. G. ALAN MARLATT: Sure. LARRY: And as a result of that, we go back to familiar surroundings and areas. Our literature, recovery literature tells us that we can never go back...(crosstalk) DR. G. ALAN MARLATT: Okay. LARRY: You know...(crosstalk) DR. G. ALAN MARLATT: That’s kind of setting yourself up for...(crosstalk)

9 minutes 30 seconds LARRY

[09:30] LARRYFor failure. DR. G. ALAN MARLATT: For failure. LARRY: Exactly and I tell them my story, how I got so full of myself and I wanted to see and show all my friends that I used with the stuff, you know, I am clean, you too can get clean and look at me, you know, I’m shining, I’m not doing that, you’re still doing that, it’s kind of like putting myself on a pedestal, you know. DR. G. ALAN MARLATT: Right, Instead of really being supportive and

10 minutes 5 seconds DR. G. ALAN MARLATT

[10:05] DR. G. ALAN MARLATTsharing. LARRY: Exactly, exactly and grandiosity. In

10 minutes 10 seconds LARRY

[10:10] LARRYactuality, I wasn’t helping nobody, I was showing all, you know, and not paying attention to the literature. I am not being aware of people places and thing, shows me sitting here and talking, I set myself up for fake and it was easier for them to get me back and into what I used to do, as opposed of me trying to change somebody, you know...(crosstalk) DR. G. ALAN MARLATT: Okay. LARRY: And get them sober and I was introduced right back to the same lifestyle and here I go again, you know. DR. G. ALAN MARLATT: Okay. So that’s a familiar

10 minutes 55 seconds DR. G. ALAN MARLATT

[10:55] DR. G. ALAN MARLATTstory. LARRY: Absolutely. DR. G. ALAN MARLATT: So now you can see, I mean, you’re helping yourself as well as helping these other people. LARRY: Oh yeah, I think so,

11 minutes 5 seconds LARRY

[11:05] LARRYI think so, you know, and I try to be humble, you know, coming with the sense of arrogance, you know, I think that’s really important, being able to relate. DR. G. ALAN MARLATT: Yeah,

11 minutes 20 seconds DR. G. ALAN MARLATT

[11:20] DR. G. ALAN MARLATTI think you said at the last time that you sort of realized that for most of the time you were just trying to do it on your own...(crosstalk) LARRY: Yeah, exactly. DR. G. ALAN MARLATT: And do it your way or whatever, in the way that you’re talking about rather than trying to let go of that and sort of working with the group or with the steps, how do you put it? LARRY: Absolutely. You

11 minutes 40 seconds LARRY

[11:40] LARRYknow, for me, I find that I lose total concentration, respect or I don’t know what it is, but when an instructor, professor, or what have you is , you know, in a teaching and they seem not really be able to relate to the individuals that they are trying to send a message to, you know, I kind of get in the shut down mode and I could see that same disenchantment look in their faces when I am chairing a meeting and I remember that, you know, I say oh, I want to kind of relax him, I don’t want him to think that I’m sitting up here chairing the meeting and I’ve got all the answers, because I’m just like they are. DR. G. ALAN MARLATT: That’s right. That’s an important message, we’re are all

12 minutes 45 seconds DR. G. ALAN MARLATT

[12:45] DR. G. ALAN MARLATTpart of the same, we’re all in the same boat here and even though you are running the meeting, it doesn’t mean that you’re the captain and they are all crew or something. LARRY: Right, right. Because

12 minutes 55 seconds LARRY

[12:55] LARRYwhat I find is a lot of people who attend meetings already suffer from low self-esteem and are beating themselves up, you know, for living the type of lifestyle and doing the type of inappropriate things that they’ve been doing and it’s a sort of embarrassment, you know, and you get the courage enough to open up and share. You know, you don’t want to feel less bad, you want to feel a part of...(crosstalk) DR. G. ALAN MARLATT: A part of, right. Like a real alliance. LARRY: Yeah. I have to keep that upfront and remember that, you know, when I try to send a message. I don’t try to criticize, I think people lose the audience attendance when they get it into their criticism mode, you know. DR. G. ALAN MARLATT: Now,

3: Discussing Philosophies of AA

14 minutes 0 seconds DR. G. ALAN MARLATT

[14:00] DR. G. ALAN MARLATTI think that is a big part of why these groups work, because people feel, you know, quite a lot of shame and stigma anyway. So if you are trying to put yourself above them in someway, it just increases that sense of...(crosstalk) LARRY: It does.

14 minutes 15 seconds DR. G. ALAN MARLATT

[14:15] DR. G. ALAN MARLATTI am here and they’re there or whatever, right? . In terms of, if you’re helping these people deal with issues maybe, they are struggling with relapse or urges or cravings that they are having...(crosstalk) LARRY: Okay. DR. G. ALAN MARLATT: And AA has certain slogans like, Halt, Don’t get too hungry, angry, lonely or tired...(crosstalk) LARRY: Tired, right, right.

14 minutes 40 seconds DR. G. ALAN MARLATT

[14:40] DR. G. ALAN MARLATTAnother one I’ve heard is thinking through the drink. LARRY: Thinking through the drink. I

14 minutes 45 seconds LARRY

[14:45] LARRYam not really familiar with that one. I can only tell you what was suggested to me when I first come around the rooms, you know, because I was suffering from quite a few afflictions, you know, drug addiction, alcoholism, sexual addiction. You know, I was addicted to a lot of things, you know, and I had the slow crawl, but what was really helpful to me is listening to people share their experiences, stress and hope, and recognizing the similarities. Some of the stories in history background were not as devastating as mine, but some of them were. Some of ‘em went a little further and has some real touching story and as a result, they told me what they did, you know, to hang on, how they fought those urges. You know, basically keeping it simple, first of all is no shame in having an urge...(crosstalk) DR. G. ALAN MARLATT: Good point. LARRY: It’s really not, you know what was suggested to me is you have to speak on it. You can’t keep it in and not share it, you know, because there is thought pattern that takes place, and if you think about it too long, you act on it. DR. G. ALAN MARLATT: Okay. So that’s a good point right. So

16 minutes 50 seconds DR. G. ALAN MARLATT

[16:50] DR. G. ALAN MARLATThow do you keep yourself from acting on it? LARRY: Okay. The

16 minutes 55 seconds LARRY

[16:55] LARRYway that was suggested to me was first of all, you find a friend, not a using friend, but a sober friend...(crosstalk) DR. G. ALAN MARLATT: Okay. LARRY: And explain to your friend that you have an urge, you feel like getting a drink, you feel like going to get some drugs, boozing, or whatever it is that you used to do and you have these drug dreams, you will be drifting thinking about using, instead of climbing in a shell and not sharing that information with anybody and then eventually acting out on it, you need to speak and tell somebody. Okay, say you’re not comfortable in a group setting. Pull an individual that share a common bond with or have some genuine respect for, you know, and share that information with that one individual. You know, some people are not comfortable in a group setting...(crosstalk) DR. G. ALAN MARLATT: Sure. LARRY: And they will shut down and keep that and entertain that thought for days and eventually act on it. DR. G. ALAN MARLATT: So, if you keep it secret, it sort of builds up, would you say or...(crosstalk) LARRY: It definitely builds up. We have a saying about tell on a disease before it tells on you...(crosstalk) DR. G. ALAN MARLATT: That’s good, I haven’t heard that one. LARRY: Yeah, yeah. And what you do is you’re freeing yourself, see because it is a “we” program not a “me” program. You know, together we can help one another make it through a trying time, an issue a day you know, when you can’t go with alone, use prayer, I suggest use prayer, you know. Now, that’s for those who are religiously inclined, you know, everybody does not believe in God. So, you have to respect the rights of others in that area too, you know, that happened to work for me. It may not work for another individual because he might be an atheist, you know, but there are other things that one can do...(crosstalk) DR. G. ALAN MARLATT: Okay. Like what?

19 minutes 35 seconds LARRY

[19:35] LARRYOkay, say tell somebody get to a meeting . DR. G. ALAN MARLATT: Get to a meeting. LARRY: Get to a meeting. DR. G. ALAN MARLATT: Right. LARRY: See, because what's taking place, your body is going through a chemical reaction . You know, specially if you were addicted or had alcoholism for a lot of years, ...(crosstalk) DR. G. ALAN MARLATT: Yeah. LARRY: And then just cut it off like that. No. The body still wants to...(crosstalk) DR. G. ALAN MARLATT: You’ve got endorphins...(crosstalk)

20 minutes 5 seconds LARRY

[20:05] LARRYThose endorphins, you know, is used to those chemicals, you know, and what you are doing is you cold turkey it , you know. DR. G. ALAN MARLATT: That's right. LARRY: The man is saying I want to stop , but the body says feed me. DR. G. ALAN MARLATT: Okay. LARRY: I want some, you know . DR. G. ALAN MARLATT: Right. LARRY: And, and, and, it's not rare. It's quite common . DR. G. ALAN MARLATT: Sure. So, you were saying earlier about urges, that it's okay

20 minutes 35 seconds DR. G. ALAN MARLATT

[20:35] DR. G. ALAN MARLATTto have them there. LARRY: Yeah. DR. G. ALAN MARLATT: That's part of really what's going on. LARRY: Absolutely. DR. G. ALAN MARLATT: You can't make your body not feel that way. Right? LARRY: You can’t. DR. G. ALAN MARLATT: But you have to want to work with it when it's happening, so you don't have to get sucked in by it or dictated by it or something. LARRY: Yeah. One of the biggest things I believe

20 minutes 55 seconds LARRY

[20:55] LARRY, we do, we're so secretive, you know. We don't want to let anybody in to how we really feel or what's going on inside and that's an important factor in recovery, it’s opening up and letting somebody in. DR. G. ALAN MARLATT: Yeah. LARRY: They say a close mouth won’t get fed, you know, how can I help you if you don't tell me where the pain is. DR. G. ALAN MARLATT: Right. LARRY: You understand what I am saying?

21 minutes 25 seconds DR. G. ALAN MARLATT

[21:25] DR. G. ALAN MARLATTYeah. LARRY: And it's no shame at all

21 minutes 30 seconds LARRY

[21:30] LARRY. We have to let us stop beating ourselves up and stop feeling less than. The sober way of living is new for a lot us, and we just have to give it an honest try...(crosstalk) DR. G. ALAN MARLATT: Sure. LARRY: To reach out to somebody and we may not have the answers ourselves but when you reach out to somebody, they can assist you or either they can make a 12-step call. A lot of times, all we need is somebody to sit it out with us. DR. G. ALAN MARLATT: Sure. It just gets to like phases

22 minutes 10 seconds DR. G. ALAN MARLATT

[22:10] DR. G. ALAN MARLATT. LARRY: Absolutely. DR. G. ALAN MARLATT: Now, what about if you were alone, like say, it was late at night and the urges are coming on. Is there something that you can do or have done to help you get it through when you...(crosstalk) LARRY: No. DR. G. ALAN MARLATT: Do you have the opportunity to tell somebody or is that when you do the prayer or? LARRY: Okay

22 minutes 30 seconds LARRY

[22:30] LARRY. For me, once again I have to go along with my religious belief. You know, I happen to believe in a creator and I pray, you know. I talk to my creator .. I don't believe in rituals of, you know , Hail Mary and bowing, bending on one knee and all . I speak to my creator just like you and I talk. DR. G. ALAN MARLATT: Okay. LARRY: You know, and I don't have to put on no garment or nothing, you know, if I’m in pain , I'll just say, "Oh God, would you help me through this one?"

23 minutes 10 seconds DR. G. ALAN MARLATT

[23:10] DR. G. ALAN MARLATTOkay. LARRY: You know, you know my situation. You understand

23 minutes 15 seconds LARRY

[23:15] LARRYwhat I am going through. I’m having these urges, these flashes and I need some help. DR. G. ALAN MARLATT: Okay. LARRY: You know, and for me, a lot of times that works . In the event, if that doesn't work, I have a sponsor that I can call. DR. G. ALAN MARLATT: You can call 24 x 7 sort of thing, right?

23 minutes 40 seconds LARRY

[23:40] LARRYIn the rules of recovery, these 12-step program it has been suggested that we take down certain numbers of different members of the group. We'll give you their phone numbers. Just in special events like this, you know, that you may be struggling in your hour of need and you need to reach out to somebody, now you have a list of numbers that you could call . DR. G. ALAN MARLATT: So that's great. So while the prayer is also kind of sharing, but you are sharing it with

24 minutes 15 seconds DR. G. ALAN MARLATT

[24:15] DR. G. ALAN MARLATTdivine being. LARRY: Absolutely, absolutely. DR. G. ALAN MARLATT: And then that's a backup you've got real people to call and...(crosstalk) LARRY: Well, I personally believe the creator

24 minutes 25 seconds LARRY

[24:25] LARRYworks through people. DR. G. ALAN MARLATT: Okay. LARRY: And I believe that he'll send someone to assist you in your darkest hour, you know, but then that's what I believe, you know. There are certain things it’s suggested that we must do ourselves, you know . You know, they say if you wanna eat, you have to work . DR. G. ALAN MARLATT: Okay. LARRY: So, I mean, we can't just sit on our laurels and expect everything to turn out all right. DR. G. ALAN MARLATT: Right. LARRY: You know. DR. G. ALAN MARLATT: You have to do certain things

25 minutes 10 seconds DR. G. ALAN MARLATT

[25:10] DR. G. ALAN MARLATTyourself. LARRY: Absolutely, and to take the initiative too.

25 minutes 15 seconds LARRY

[25:15] LARRYYou're busy, you know, and due to work. DR. G. ALAN MARLATT: Okay.

4: Client's Recovery Experience

25 minutes 20 seconds LARRY

[25:20] LARRYRight. DR. G. ALAN MARLATT: So do you have any problems

25 minutes 25 seconds DR. G. ALAN MARLATT

[25:25] DR. G. ALAN MARLATTwith urges yourself or triggers that still come up?

25 minutes 30 seconds LARRY

[25:30] LARRYTo be honest, not nearly as bad as when I first got in recovery. DR. G. ALAN MARLATT: Okay. LARRY: You know, boy, I’m telling you, I could see somebody participating in something and I get the cold sweats, you know nose would twitch, you know. DR. G. ALAN MARLATT: That's the physical sensation, right?

26 minutes 0 seconds DR. G. ALAN MARLATT

[26:00] DR. G. ALAN MARLATT. LARRY: Mouth would water, you know. It was bad

26 minutes 5 seconds LARRY

[26:05] LARRYfor like first 30 to 60 days. Oh. DR. G. ALAN MARLATT: Those are the worst. LARRY: It didn't take much, you know, I was easily influenced, but I mean the more the days and the months go by, you know, the stronger I believe I get . I still don't try to test my boundaries though. Certain places , I won't go. DR. G. ALAN MARLATT: Okay. Like what? LARRY: Okay . Say a family outing that there is a whole lot of drinking and stuff going on . DR. G. ALAN MARLATT: Okay. LARRY: As much as I love my family, I refuse to participate in that, you know. DR. G. ALAN MARLATT: Okay. LARRY: You know. Because I know a lot of shenanigans, or lot of different things going on there. They have the VIP room, you know, where all the addicts and alcoholics get together and do their thing . DR. G. ALAN MARLATT: Yeah. LARRY: And I try to avoid places like that. Lounges . If I have no particular reason to go to a lounge area or something, I may go in a group setting. Say that there is a group of us from recovery and we go as a collective group. We can each watch each other's back , but I would not suggest to a newcomer to go to a lounge, you know, that's just not done . That's like a tempting phase. DR. G. ALAN MARLATT: Okay. So you’re kind of

27 minutes 50 seconds DR. G. ALAN MARLATT

[27:50] DR. G. ALAN MARLATTmaking sure you don't put yourself in situations where there could be...(crosstalk) LARRY: Absolutely

27 minutes 55 seconds LARRY

[27:55] LARRY. DR. G. ALAN MARLATT: Lots of temptations and if you are not with other people that are

28 minutes 0 seconds DR. G. ALAN MARLATT

[28:00] DR. G. ALAN MARLATTin recovery, that puts you at a particular risk, not just you of course, but people in that kind of, when they are that vulnerable. Right? LARRY: Exactly

28 minutes 10 seconds LARRY

[28:10] LARRY. You know, you may not be familiar with but like a lot of times we have to make what's called 12-step calls and mercy or rescue, aid and assistance where we have an individual that really needs a ride or need some support and is in a location of a negative zone or area, and he wants a show of strength to come in and assist him out of there, you know, then a few adult was called and now a lot of times it’d be a house of ill repute, you know . DR. G. ALAN MARLATT: Yeah, sure I am. LARRY: It is suggested that we wait outside. You know, we don’t like going inside, to get in, you know, but it’d somebody that's for whatever reason fell off the wagon...(crosstalk) DR. G. ALAN MARLATT: Yeah. LARRY: Slipped, fell and comes to the realization that they don’t wanna go no further so they utilize the phone and call for some help. DR. G. ALAN MARLATT: So even though they've fallen off the wagon, they’re are still able to do something to get help

29 minutes 35 seconds DR. G. ALAN MARLATT

[29:35] DR. G. ALAN MARLATTbefore they...(crosstalk) LARRY: Absolutely. Or some of them are. DR. G. ALAN MARLATT: Some of them are...(crosstalk). LARRY: Some of them are, you know

29 minutes 40 seconds LARRY

[29:40] LARRY, that don't happen for all of recovery and alcoholics and addicts. Sometimes an individual can stop long enough to make a call. DR. G. ALAN MARLATT: Right. LARRY: Sometimes you can't put on brakes . DR. G. ALAN MARLATT: Okay. LARRY: And the sad part about it, a lot of times, a lot of cases then result in OD, overdose. DR. G. ALAN MARLATT: Yeah

30 minutes 5 seconds DR. G. ALAN MARLATT

[30:05] DR. G. ALAN MARLATT. LARRY: Be caught off in the wrong place and received

30 minutes 10 seconds LARRY

[30:10] LARRYsome inappropriate behavior as a result of chasing and looking for drugs and alcohol, and leading up to being beaten up, bludgeoned, whatever. You know, shot those things happen too...(crosstalk) DR. G. ALAN MARLATT: Those things, you told me those things happened to you a few times.

30 minutes 35 seconds LARRY

[30:35] LARRYOh yeah. DR. G. ALAN MARLATT: a few times. LARRY: Oh yeah. I’ve been on the receiving end and the giving end, you know . DR. G. ALAN MARLATT: Yeah. LARRY: You know. DR. G. ALAN MARLATT: Oh, you were saying about people falling off the wagon and then it's

30 minutes 45 seconds DR. G. ALAN MARLATT

[30:45] DR. G. ALAN MARLATTcritical, what happens? Either to pull them, help them back on track or they just. A lot of people, I don't know if this happened to you, but just go, it shows I can't do it right? because I can't maintain abstinence. LARRY: Yeah. DR. G. ALAN MARLATT: So, working with that is...(crosstalk) . LARRY: That's really important. I find it’s

31 minutes 5 seconds LARRY

[31:05] LARRYimportant to assist somebody in those first few hours, you know, to help try to put on brakes and get back on that horse of recovery . DR. G. ALAN MARLATT: Yeah. LARRY: There’s a tremendous amount of shame and guilt that goes along with relapse and...(crosstalk) . DR. G. ALAN MARLATT: Yeah. LARRY: You know, that keeps people away from rooms of recovery . DR. G. ALAN MARLATT: Yeah. That's what we’re trying to get at. So, when people are feeling that way, what's the best message you get?

31 minutes 40 seconds LARRY

[31:40] LARRYWell. DR. G. ALAN MARLATT: What worked for you? LARRY: You know, you can be passive, you can be too critical . You know, you have to find a middle route. DR. G. ALAN MARLATT: Okay. LARRY: As far as, see because as people, we affect one another and if you've been in recovery for a certain amount of time, you've broken bread with people, you've been to each other's houses, you've shared some intimate details , and you've bonded, and for an individual that you've bonded with fall off the wagon, you know, you feel betrayed in an instance, you know. DR. G. ALAN MARLATT: Okay. LARRY: And the first reaction one feels is anger. DR. G. ALAN MARLATT: Okay. Right. LARRY: You know...(crosstalk)

32 minutes 30 seconds DR. G. ALAN MARLATT

[32:30] DR. G. ALAN MARLATTThat’s understandable . LARRY: And you want to express that anger to the individual

32 minutes 40 seconds LARRY

[32:40] LARRYwho has fallen off the wagon. You have to real mindful though because this is a critical time in their life. DR. G. ALAN MARLATT: Yes

32 minutes 50 seconds DR. G. ALAN MARLATT

[32:50] DR. G. ALAN MARLATT. A big fork in the road right there, right? LARRY: They already have a

32 minutes 55 seconds LARRY

[32:55] LARRYtremendous amount of guilt and humiliation , you know, because they may accumulated it some years. DR. G. ALAN MARLATT: Right. The longer...(crosstalk) LARRY: They may have accumulated ...(crosstalk). DR. G. ALAN MARLATT: One of them may be calling right now

33 minutes 15 seconds DR. G. ALAN MARLATT

[33:15] DR. G. ALAN MARLATT. Well, that's okay. LARRY: Maybe he'll go away, but what I am trying to say

33 minutes 20 seconds LARRY

[33:20] LARRYis, I've seen it happen often, you know, sometimes we can be too critical . DR. G. ALAN MARLATT: So, first he’s feeling guilty and then if you are getting angry at them,

33 minutes 30 seconds DR. G. ALAN MARLATT

[33:30] DR. G. ALAN MARLATTit's just...(crosstalk) LARRY: It's counterproductive. It truly is. You can shut them

33 minutes 35 seconds LARRY

[33:35] LARRYdown. You can make him feel less bad. You can make them feel ostracized and then once they give up and go on the tar, then they sing the old addicts’ national anthem, ethnic, you know. DR. G. ALAN MARLATT: The ethnic response. LARRY: I’ve been messed up , so ethnic. I am as well...(crosstalk) DR. G. ALAN MARLATT: Yeah. So that happens a lot

34 minutes 5 seconds DR. G. ALAN MARLATT

[34:05] DR. G. ALAN MARLATT, right? So LARRY: Yeah. I might as well, go all the way. DR. G. ALAN MARLATT: Yeah, . I have not yet have gone this far plus all my people or friends are not getting angry at me...(crosstalk). LARRY: I’ve a lot of respect from my peers. DR. G. ALAN MARLATT: Right. LARRY: You know, that's

34 minutes 15 seconds LARRY

[34:15] LARRY, it's, but we as individuals we do it all the time. DR. G. ALAN MARLATT: Sure. LARRY: And now, and it's more about thinking about our feeling as opposed to thinking of their feelings. DR. G. ALAN MARLATT: Okay

34 minutes 30 seconds DR. G. ALAN MARLATT

[34:30] DR. G. ALAN MARLATT. That would make a difference there, right? LARRY: Oh, you know the difference, you know.

34 minutes 35 seconds DR. G. ALAN MARLATT

[34:35] DR. G. ALAN MARLATTSo, it's not like you are getting angry at somebody who falls off the wagon, or we’re the one who fell fall off the wagon and feeling guilty? What's the better way of responding, because you're not going to say, "Oh, it's okay." You know. LARRY: No. No. DR. G. ALAN MARLATT: But, you search a middle way, right so? LARRY: You got to find middle ground...(crosstalk)

34 minutes 55 seconds DR. G. ALAN MARLATT

[34:55] DR. G. ALAN MARLATTMiddle ground. What I found worked for me is I listen to ‘em, you know, and I really tell them, and I say okay, are you through, you know , I say you called me. Here I am. Okay. LARRY: Are you through

35 minutes 20 seconds LARRY

[35:20] LARRY? You know, or you called me for something else? You are Sam? . First of all, I want to know, are you through running? Are you through doing whatever it is that you were doing, you know, I said okay.

35 minutes 35 seconds DR. G. ALAN MARLATT

[35:35] DR. G. ALAN MARLATTYeah. LARRY: This is what happened to me

35 minutes 40 seconds LARRY

[35:40] LARRYwhen I slipped, when I fell off the wagon, you know, and then our stories start to become similar. You know, I say well, you are not doing okay , and I’m shamming and I had an urge and I didn't want to tell nobody about it. I kept it a secret and a new phase, I wanted to act out, you know, and eventually the urge took over me and I had a feel what it was like one more time, you know, I thought I was cured. DR. G. ALAN MARLATT: Yeah. And here it is again

36 minutes 20 seconds DR. G. ALAN MARLATT

[36:20] DR. G. ALAN MARLATT. LARRY: But after realizing, after I ran out of my money

36 minutes 25 seconds LARRY

[36:25] LARRYand I realized this way of life was not working and I was steadily getting deeper and deeper. I called out for some help . Then I told him are you willing to do whatever it takes to stay sober? You know. Ask yourself that, you know. DR. G. ALAN MARLATT: Yeah. LARRY: And say, okay, if you say yes, then this is what I want you to start doing . First of all, you know, make a meeting ...(crosstalk) DR. G. ALAN MARLATT: Yeah. First things first, right?

37 minutes 0 seconds DR. G. ALAN MARLATT

[37:00] DR. G. ALAN MARLATT. LARRY: You know, first of all, make a meeting, but I try to stay away from criticizing...(crosstalk) DR. G. ALAN MARLATT: Okay. LARRY: You know,

37 minutes 5 seconds LARRY

[37:05] LARRYbecause, number one, no one’s perfect . DR. G. ALAN MARLATT: Right. LARRY: And I don't want to make them feel inadequate or less bad. They are already...(crosstalk) DR. G. ALAN MARLATT: Feeling that way

37 minutes 20 seconds DR. G. ALAN MARLATT

[37:20] DR. G. ALAN MARLATT. LARRY: Feeling bad, you know, because they

37 minutes 25 seconds LARRY

[37:25] LARRYslipped up and made an error of poor judgment, you know, and for me to criticize them would be to admit like I have never made a mistake. DR. G. ALAN MARLATT: Right, so it's sort of right

37 minutes 40 seconds DR. G. ALAN MARLATT

[37:40] DR. G. ALAN MARLATT; setting up perfection and expectations were, you said, like an error. I mean, we all make mistakes. LARRY: Absolutely. DR. G. ALAN MARLATT: As part of our human...(crosstalk) LARRY: Absolutely, you know, and

37 minutes 50 seconds LARRY

[37:50] LARRYrefrain from that profanity. DR. G. ALAN MARLATT: Okay. LARRY: You know. DR. G. ALAN MARLATT: Right

37 minutes 55 seconds DR. G. ALAN MARLATT

[37:55] DR. G. ALAN MARLATT. So there is empathy there and there is some sense of I know where it's out for you because I've been there. It doesn't mean it's over and go to a meeting, and...(crosstalk) LARRY: Right. Are you willing to do what it takes to stay sober

38 minutes 10 seconds LARRY

[38:10] LARRY? You already see that other way is not working. DR. G. ALAN MARLATT: Right. So, that's part of what you can learn from these. LARRY: Yeah. And a lot of times, a lot times, a person will gain so much strength from a relapse. DR. G. ALAN MARLATT: Yes. LARRY: You know, if they make it back . DR. G. ALAN MARLATT: Right. You think they tend to swing around, right? LARRY: Yeah, if they are willing to try and do something about it. DR. G. ALAN MARLATT: Yeah. LARRY: You know, lot of sounds we can wallow in it. DR. G. ALAN MARLATT: Well, that's true. That would be the other way to go. LARRY: Yeah. And well , I didn't think it would go and work in the first place. DR. G. ALAN MARLATT: Yeah, sort of

38 minutes 50 seconds DR. G. ALAN MARLATT

[38:50] DR. G. ALAN MARLATTconvince yourself that you can’t do it or something, right. This just proves I’m addict or...(crosstalk) LARRY: Well, you knew I was alcoholic

38 minutes 55 seconds LARRY

[38:55] LARRY. DR. G. ALAN MARLATT: Yeah. Really. We get stuck for an alcoholic

5: Summary

39 minutes 0 seconds DR. G. ALAN MARLATT

[39:00] DR. G. ALAN MARLATT, right? LARRY: Right, you know. DR. G. ALAN MARLATT: Well, that's really an important message, Larry, to tell people that because that’s really the time when a lot of people just drop out of treatment or they give up or they just throw in the towel. LARRY: Yes, absolutely, and those are critical times

39 minutes 15 seconds LARRY

[39:15] LARRY, you know, and if they really want to reach somebody , you know, you have to be open and honest a little, and no criticism . Share your own experience and hopes and say "Look, this is what happened for me. This is what I did to turn it around. Are you willing to do this? At least this?" You know. DR. G. ALAN MARLATT: Yeah. You can share with them what happened to you

39 minutes 45 seconds DR. G. ALAN MARLATT

[39:45] DR. G. ALAN MARLATTand how it worked for you instead of coming down on them, gives them a sense of hope and inspiration in a way. LARRY: Yeah

39 minutes 55 seconds LARRY

[39:55] LARRY. DR. G. ALAN MARLATT: Coming to that realization doesn't happen overnight,

40 minutes 0 seconds DR. G. ALAN MARLATT

[40:00] DR. G. ALAN MARLATT. You know, it takes a minute being in recovery to realize that, you know, because early on you know, you really acting out on emotions and feelings, and like I said, this individual bonded with you, you know, you’re feeling hurt, you’re feeling that they let you down. You know, you're taken it personally. LARRY: Yeah, yeah. Right. DR. G. ALAN MARLATT: You know, this was my buddy , my pal, and I am making it ...(crosstalk) LARRY: You let me down by doing that.

40 minutes 35 seconds DR. G. ALAN MARLATT

[40:35] DR. G. ALAN MARLATTYeah. You were supposed to make it with me, you know, and you like the drugs more than you like me ? LARRY: Do you know what I am talking? DR. G. ALAN MARLATT: No, it's a natural reaction. You do give in to your natural reactions and some by just telling them like your own story and so forth is actually sharing instead of criticizing. LARRY: That's what I found works, you know

40 minutes 55 seconds LARRY

[40:55] LARRY, and I have to stick with what works. DR. G. ALAN MARLATT: Oh really.

41 minutes 0 seconds LARRY

[41:00] LARRYI don't want to pour salt on the wound, you know. I want to help somebody. I don't want to hurt anybody . It’s easy to step on somebody's neck when they’re down? DR. G. ALAN MARLATT: Yeah. I know. LARRY: Yes. DR. G. ALAN MARLATT: This is just a natural

41 minutes 15 seconds DR. G. ALAN MARLATT

[41:15] DR. G. ALAN MARLATTtendency, but sometimes you have to do something that goes against your natural tendency that can be really helpful. LARRY: You do, you do, and try to put that upfront

41 minutes 25 seconds LARRY

[41:25] LARRYand remember that that's a crucial on time for them . DR. G. ALAN MARLATT: Right. LARRY: You know, you could send them in one direction or another. DR. G. ALAN MARLATT: Right. And that’s that critical moment. LARRY: Yeah, it is.

41 minutes 40 seconds DR. G. ALAN MARLATT

[41:40] DR. G. ALAN MARLATTSo, we just have a couple of minutes left. Is there anything in addition to help people with relapse that might be helpful for them if they knew about it? LARRY: Well

41 minutes 50 seconds LARRY

[41:50] LARRY, I would strongly suggest purchasing some literature on recovery, you know. We have several different 12-step programs and either one is fine because they all talk about recovery and how the program works, you know. DR. G. ALAN MARLATT: Yeah. That's true. LARRY: So whichever 12-step program that they have gravitated to, I would strongly suggest to purchase that literature and read it. DR. G. ALAN MARLATT: I know, and not just have it

42 minutes 35 seconds DR. G. ALAN MARLATT

[42:35] DR. G. ALAN MARLATTaround. LARRY: You are right, you know. Open up the book

42 minutes 40 seconds LARRY

[42:40] LARRY. The recovery is in the book, you know, and once you read it and then try to apply it to the best of your ability, you know. DR. G. ALAN MARLATT: Yeah. I think the reading

42 minutes 50 seconds DR. G. ALAN MARLATT

[42:50] DR. G. ALAN MARLATTthing is very important, but also what you are doing in terms of like the work with the homeless group.

42 minutes 55 seconds LARRY

[42:55] LARRYOh yeah. DR. G. ALAN MARLATT: That's the 12-step

43 minutes 0 seconds DR. G. ALAN MARLATT

[43:00] DR. G. ALAN MARLATT. Isn't the 12-step...(crosstalk) LARRY: It is...(crosstalk) DR. G. ALAN MARLATT: Taking the...(crosstalk) LARRY: After having the spiritual awakening as a result of these steps, they have to

43 minutes 5 seconds LARRY

[43:05] LARRYshare and give it back, you know.

43 minutes 10 seconds DR. G. ALAN MARLATT

[43:10] DR. G. ALAN MARLATTYeah. LARRY: And that's what we do.

43 minutes 15 seconds DR. G. ALAN MARLATT

[43:15] DR. G. ALAN MARLATTRight. That's what you’re doing. You know, that's wonderful that you are able to give. LARRY: Oh, thank you, thank you

43 minutes 20 seconds LARRY

[43:20] LARRY. I just remember where I came from, you know, and the program works. I’d tell anybody, you know, the program works.

43 minutes 35 seconds DR. G. ALAN MARLATT

[43:35] DR. G. ALAN MARLATTWell, it works because people like you are out there helping people in ways that are you know, amazingly helpful and compassionate . So, out time’s up today, but I felt it was very helpful for me ...(crosstalk) LARRY: Oh, okay. DR. G. ALAN MARLATT: To hear how different strategies can work and we can pass it on to other people. LARRY: Thank you. My pleasure. DR. G. ALAN MARLATT: We will talk more about it next time we meet. LARRY: Okay. See you again later. DR. G. ALAN MARLATT: Okay. Thank you.