Clean by David Sheff

Clean: Overcoming Addiction and Ending America's Greatest Tragedy, David Sheff.  New York: Houghton Mifflin Harcourt, 2013.  e-book 339 pps. with additional notes afterwards.

Some folks may have read David Sheff's book Beautiful Boy about his son's addiction and subsequent recovery.  David Sheff's newest work Clean is a somewhat repetitive overview of treatment for addictions based on the idea that the addict is suffering from a condition which interferes neurologically with proffered help to recover from said condition.  David Sheff correctly points out that addiction is not the only condition [he uses the word "disease," a word which I maintain is not precise enough and does not go far enough in describing addiction] that results in a thick layer of denial.  Other examples are some forms of dementia and traumatic brain injury [dependent upon where the lesions are in the brain itself]; and diabetes.

Sheff builds a case for treating addicts as people who are suffering from a physical condition rather than as people who need to find a god, get right with a god, pray, meditate, or look deep within for the defects which caused them to want to get loaded in the first place.  The problem with those who are caught up in active addiction is that their brains do not allow them the cognition which tells regular folks that they have to change what they are doing.  Sheff advises that cookie cutter grouping of addicts in a rehab doesn't work because of this.  Some addicts may be ready before others are to learn about addiction.

One takeaway from Clean is that the rehabilitation system ought to stop punishing addicts by throwing them out of treatment for doing things that addicts do.  Another is that legal system ought to quit punishing addicts or furnishing consequences for their behaviors which arise from their abnormal neurological states.  A third is that the sooner we quit treating addicts as if they were bad little boys and girls, the better off everyone will be.  I cannot agree with the first and the second points in their entirety, but I do endorse the third.  Every sick patient deserves basic human respect.  Although the etiologies of some particular cancers are demonstrably related to the quantity of fat consumed in a diet, no cancer patient is asked to confess his sins in order to receive amelioration from the cancer.  Nor is she told that she is being therapeutically discharged for puking after [or sometimes before when anticipatory vomiting takes place] a round of chemo.  There's not a whole lot of people screaming at cancer patients that their condition is their fault.  But there is a bunch of people who are sincerely butt-hurt and angry at the antics of both active addicts and addicts in recovery for a variety of reasons.  The Twelve Steps and their quasi-Christian feel in fact may not be optimal or even integral to the [formal, medical, rehabilitative] treatment of addiction.  If the scientific model of addiction is adopted then it follows that rehabs as we now commonly know them will have to change their methods.

A.A. owes its' roots to the Washingtonians-- who thrived contrary to what Bill W. claimed in his writings-- and to the Oxford group.  The first draft of the Big Book, if allowed to be published in its' original form, has a decidedly Christian slant and would have kept out a bunch of non-Christians from remaining in the rooms of Alcoholics Anonymous.  Indeed, the early A.A. groups excluded women.  Fortunately that changed.  We need more research into how to truly individualize treatment for addicts.  

sapphoq reviews says:  Although Clean was a worthwhile, if wordy, read I had some difficulty with the book.  In spite of the title, Clean deals primarily with alcoholism with the usual passing nod to addiction to other drugs.  I was initially hopeful that Clean would have some things to say about Narcotics Anonymous.  But like many books and treatment programs these days, N.A. is given a pat on the head.  I find this perpetuation of keeping addicts silent to be most distressing.  There are addicts who have barely used or never used alcohol in A.A.  They [usually are somewhat pressured to] identify as alcoholics and say things like, "Everything started and ended with alcohol."  There are also alcoholics who prefer N.A.  But unlike the addicts in A.A., the alcoholic who has never used other drugs is welcomed in the rooms of Narcotics Anonymous.  And the alcoholic almost always identifies as an addict in N.A. willingly, recognizing that the word addict includes addiction to the drug alcohol.
     Sheff does a fairly good job of describing adjuncts to recovery in the form of opiate substitutes, i.e. methadone and other medications.  He also points out the extra liability that a mental health diagnosis can be to the addict seeking recovery.  But he does not clearly offer his vision of what a treatment program using best practices might look like.  This is something that I would have been interested in hearing more about.  Not all rehabs, in-patients, out-patients, detoxes, halfway houses, and three quarter way houses are equal in their effectiveness.  Add to that the manipulation and belittling of addicts in early recovery that occurs by staff people who should know better [and by some folks with longer periods of recovery who have forgotten what they were like in early recovery], it is truly a jungle out there.
     Within the limitations that I have described, Clean is a worthwhile read for those who do not work in the addictions field and for some folks with some time away from active addiction.  Those who work in the addictions field will probably find nothing new [even if they are not implementing some of the suggestions].  And the general audience will probably be lost in the midst of all of the words.  Recommended with some hesitation.  

A.A.? No Way! by Charles Delaney

A.A.? No Way!, Charles Delaney.  Self-published, Smashwords, 2012.  ebook, 59 pps.


Some people find help in traditional [12 step] groups and traditional [based upon the 12 steps] treatment programs and rehabs.  Others don't.  Charles Delaney had been to A.A. and he found the program to be significantly lacking.  The A.A. members themselves appeared to be clones of each other.  Worse, they were not ready to hear Delaney's criticism of the program itself nor what he found in looking for alternatives.

The problem as Charles Delaney sees it is that A.A. has a 95% failure rate.  He states that Rational Recovery has a higher success rate of its members achieving abstinence than A.A. does.  He also states that folks who attempt to quit their addictions by themselves have a better chance of doing so than folks in the rooms of Alcoholics Anonymous and other Anonymous derivatives.  Delaney does quote from some studies but does not provide any footnotes for his stats.  On page 11, he says "The basic idea of those programs are the best of ideas...put to the worst of applications."  He maintains that Alcoholics Anonymous is in fact a Christian and a religious program.  He criticizes the idea that alcoholics are powerless when it comes to alcohol.  He advocates for the assuming of personal responsibility in addressing one's addiction.

A.A.? No Way! offers criticism of the twelve steps from a pagan perspective.  There is an outline of "A 9-Step Recovery for Asatru/Odinists" [which begins on page 40 in my ebook] that I personally thought were excellent.  After that, the book begins to fall apart.  Delaney endorses an old book  written by plastic surgeon Maxwell Maltz and published in 1960 called Psycho-Cybernetics.  [Psycho-Cybernetics espoused positive thinking, if you can dream it you can do it, and mind-body connection woo-woo].  He then detours into a very rudimentary understanding of brain function and creativity.  A.A.? No Way! finishes up with the idea that there is so much more out there in a life of abstinence than can be found in the rooms of Alcoholics Anonymous.

sapphoq reviews says:  Some of A.A.? No Way! rang true to me and some didn't.  To his credit, Charles Delaney was quick to point out that those who have found their help in A.A. ought to remain in A.A.  Although A.A.? No Way! lacks in footnotes and a bit of execution, it is especially valuable for those heathens who want to try some steps written specifically for them.  Quite frankly, except for the woo-woo noted within the book he recommended, I liked this little ebook.  Charles Delaney has the barebones for a longer book within the first 43 pages of A.A.? No Way! .  It is my sincere hope that he will undertake a longer book project related to alternatives to 12 step recovery, complete with footnotes but lacking the feel-good woo-woo and pop psychology that often passes for professional treatment these days.  Recommended for heathens who have failed in A.A. because of its' somewhat quasi-christian approach to recovery.

Switching Time by Richard Baer

Switching Time, Richard Baer.  New York: Crown Publishers, 2007. ebook, 295 pps.

Like a large percentage of people diagnosed with Multiple Personality Disorder or Dissociative Identity Disorder [depending up what year the diagnosis was made], Karen-- a pseudonym-- had endured horrendous abuse by her family as a child.  Subsequently, she hooked up with an abusive mate.  In her struggle to break free of that, she began therapy with Richard Baer.

At some point, Karen's alters began to surface and communicate with her therapist.  They had a litany of complaints.  Karen herself was conscious only of losing time.  Losing time is like an alcoholic blackout caused by the shifting of alters-- the body continues to function and have a life but the brain does not remember later-- who will say and do things that the core will not.  Eventually, Karen developed co-consciousness with varying alters.  She also recovered specific memories of ritual abuse.

By the end of the book, Karen integrated and gave permission for the book to be written.  She reportedly furnished many corrections and expansions but was satisfied with the execution of her case study.

The part of the book that fascinated me was the description of Karen's parents.  Her father went to trial for the sexual abuse of a young niece.  Karen was tricked into taking her mother to the hospital to pick up her father after his discharge.  He had been found to have metastasized cancer.  In typical fashion, her parents blamed Karen for his woes.  They also had the expectation that she would drop in on her father daily to check on his well-being while her mother was away.  When she refused, they informed her that she owed this service to them and that she was an ingrate.

sapphoq reviews says: Switching Time is the typical story of woman diagnosed with multiple personalities written by her therapist after her integration.  Those singletons who enjoy television shows where laundry is aired in public and those who are fascinated by the concept of multiple personalities will probably like Switching Time.  I hesitate to recommend Switching Time.  There is something about not wishing to encourage other folks on the D.I.D. continuum to allow their stories to be told by professional helpers.  Those who are triggered by reading about childhood sexual abuse ought to stay away entirely.  On the question: Can more than one "personality" exist in one body? I remain neutral.  I want to say that horrific childhood abuse can do that to someone.  Yet I hesitate because the literature is also filled with stories of childhood "satanic" ritual abuse and references to snuff films.  Sort of not recommended.    

The Anti-Therapist by Keaton Albertson

The Anti-Therapist: Interrogations and Interventions with Sex Offenders, Keaton Albertson.  Self-Published e-book, Keaton Albertson, 2012.  528 pps.

In researching the troubled teen industry, I became curious as to whether or not some sects of the [fundamentalist variety; that is to say the fringe polygamist sects] Latter Day Saints had the underpinnings of an abuse culture.  I came across several e-books by Keaton Alberton.  Keaton Albertson grew up in a Mormon household but departed from that faith as he rocketed into adulthood.  The Keaton Alberton books had nothing to do with the question of abuse culture or the troubled teen industry.  Samples convinced me to read them anyways.  So here is the first one that I've read.

As a young man, Keaton Albertson got a job as a treatment facilitator.  He had to interview various predators who were locked up for treatment as part of their sentences for their various disgusting crimes.  Their crimes were truly disgusting.  And so were some of their behaviors on their living units.  Keaton's clientele included folks who did things with their grandchildren, with barn animals, with shit, and with anything filthy imaginable.  They were required to disclose a full sexual history.  Their perversions were worse than anything that I've seen on television.  And these guys saw nothing wrong with things like trying to get a horse to administer oral sex [FAIL], beating on a Staffordshire terrier and then trying to get it to give them oral sex [FAIL], masturbating with feces in public toilet stalls that were vacated by little girls [FAIL], stealing underwear from a garage sale [FAIL], ejaculating into a hole they secretly created in their neighbor's kid's teddy bear and then leaving it on the pillow uncleaned to fester when the neighbors weren't at home [FAIL].  In spite of the subject matter, I laughed uproariously at Keaton's descriptions of each interview and situation that he ran into.  I don't think I will quite forget for a long time the likes of a dude who left little piles of constipated shit in the communal shower stall at the treatment facility or the guy who stole hot sauce from the cafeteria to use as a lubricant during his special moments with his penis and testicles.  Keaton's story-telling ability shone throughout the book.  The truly frightening thing about this book is that the guys that he described really do exist.  And until they get caught, they are out in public doing things or possibly next door having pool parties and mowing the lawn.  

Keaton also recounted his escapades with a couple of buddies from work after-hours.  And a new boss that he named Assclown who certainly resembled his moniker.

A friend of mine from high school used to hang out quite a bit at her apartment.  Her mother was a stout Irish woman who used to tell us all of the time that "Truth is stranger than fiction."  [She also told us more than once that we stank like a brewery when we descended upon the apartment after a drinking spree in college].  To which I can say, "Yeah.  Truth certainly is."  The Anti-Therapist is a perfect illustration of that motto.

I never really cared for my snooty neighbors-- the ones with the pool parties and mowed lawn-- but now I am leery of them as well. It's far too easy to picture them doing all kinds of really demented sexual stuff while putting on a good front around town.  Just makes me want to go live in a cave very far away from anyone and anywhere.

sapphoq reviews says:  If you object to sexual topics or cursing, then don't read this book.  But if you are able to deal with f-bombs and weird things you've never thought about, then The Anti-Therapist is a winner.  It helps if you've read enough John Douglas or have a decent background in anything related to true crime or perps and how they pick their targets.  Keaton Albertson is a winner of a writer.  I'm looking forward to reading more of his books.  Highly recommended.