No Lost Causes

My all time favorite TV show is MASH. I’ve seen every episode at least ten times. There’s this scene in which Hawkeye is performing a surgery that’s going badly and he yells at his patient, “Come on damn it, live! Don’t let the bastard win!” An onlooker asks who he’s referring to and Colonel Potter looking especially solemn says simply, “Death.”

My friend Ardis says this to people in power, “You’re counting beans and we’re counting bodies.” Until it hits close to home, it’s easy to pretend that the disease of addiction doesn’t kill. It does. Every day. Late stage alcoholism and addiction are dark and dangerous places where hope does not often appear.

It’s easy to write people off as a lost cause. The helping and healing professions have lots of language for why a client is getting worse instead of better. We say that they are “noncompliant”, “not engaging in treatment”, “not invested”, or “unwilling to follow recommendations.” We don’t have a lot of language for ineffective professionals, programs, or organizations. We check to see that what they’re doing is “evidence based” that they are “HIPPA compliant” and that they have fire escapes clearly marked in their offices. How then are we to measure whether a person, program, or organization is effective?

In the movie Patch Adam’s Robin William’s character explains, “You treat the disease…you win, you lose. You treat the person; you win no matter what the outcome.” It seems to me that people do not really get better because their therapist has mastered cognitive behavioral interventions. Perhaps they got better because someone believed in them, cared about them, and refused to give up when things got worse before they got better. I’m not saying that theoretical knowledge and proven clinical skills are not important. I’m saying that they’re not enough.

The helping and healing professions have a lot of nice language for things that suck. We are trained to refer to such things as “challenges”, “obstacles”, “unmet needs”, and “unresolved grief and loss.” Many of us are highly educated people who seem incapable of calling a spade a spade. We do not have a meaningful vernacular for folks who are scared, ashamed, and hopeless. How do we help people overcome their “inability to regulate negative emotional experiences” (gag me)?

The first step might be to say the equivalent of, “Damn. That must be incredibly painful.” Real validation involves using real words. Personally or professionally, if we are to be of service then we must be authentic. Perhaps we struggle to bear witness to the suffering of others because we remain hindered by our own pain. Perhaps we fear having hope for those who live without it. Truth is, watching people die sucks – especially when you’re powerless to prevent it.

Real “empowerment” means giving people a sense of personal power. That means we look at the overwhelming crap in their lives and we help them break it down into small, manageable piles. Folks have to see something they can actually do to start and continue the process.

“Faith is taking the first step when you can’t see the whole staircase.” – Martin Luther King

Having faith in a person doesn’t mean you convince yourself that they can be cured. It means you believe that by God they can take care of those small piles – one at a time, one day at a time. We don’t encourage our clients to take a long view of things because it’s too much for them. It seems to me that it’s too much for us too – whether this is personal or professional. We have today and that’s all we’ve got. If you have guarantees for tomorrow let me know where you got them because I want one too.

It’s not hard to tell when someone’s given up on themselves. There’s a look of resignation – a defeated air about them. How do we give hope to the hopeless? We refuse to enable or collude with self destruction and we bring them a flashlight – some bit of applicable and simple wisdom. Just for today don’t drink. Just for today go clean the garage. Just for today go help somebody who really needs it. Just for today be around good people and don’t do that thing that always makes you miserable.

It’s a very strange thing to hate a disease. Everyone hates cancer and so we work for a cure and we go to the Relay for Life and we do what we can to further research. We ache watching loved ones go through treatment and we pray for remission. We look to their doctors and caregivers to cure them. Hating the disease of addiction is an empty, powerless feeling. There is no complete cure and remission involves overcoming an overwhelming obsession and compulsion coupled with a willingness to make enormous changes in one’s life.

The language of addiction is brutal and deceptive. I cringe when people refer to themselves as a “chronic relapser” because this is not simply a statement of their past; it is most often a prediction of their future. I’m troubled to hear people refer to conscious choices as a “slip.” The battle cry of the self defeatist is always some variation of, “F it.” It = me.

The language of recovery is based in hope. The literature of Alcoholics Anonymous does not refer to “I” or “Me.” It refers to “We.” The message is that no matter how far gone one may seem/be there is always hope. We have seen miracles. We have seen transformation and we know that all any of us have is today. For these and countless other reasons, we never, ever, give up.

“Don’t give up on me I’m about to come alive.” – Train “I’m About to Come Alive”

Jim LaPierre

About Jim LaPierre

Jim LaPierre LCSW CCS is the Executive Director of Higher Ground Services in Brewer, Maine. He is a Recovery Ally, mental health therapist and addictions counselor. He specializes in facilitating recovery (whether from addiction, trauma, depression, anxiety, or past abuse) overcome obstacles, and improve their quality of life. Jim offers a limited amount of online therapy to those with very flexible schedules.