Just jumping over from psychiatry at the margins, and I’m getting a lot out of the writing and discussion here. I work with specialty courts (“drug courts”), and while I subscribe to what I take to be more modern (individualized, autonomy and motivation focused), I interact with a lot of more old school ideas (confrontational, surrender focused). It’s especially chastening when those old school approaches seem to work. I’m always trying to figure out what vision or visions of recovery I want to offer—or if I want to have one. It seems useful to have something more than “what do YOU want?” But it seems dishonest to start making promises.
The question of recovery v wellness has come up. Intellectually, I want to say something like “recovery is a move towards wellness after an experience of powerlessness.” I think the 12 Steps are pretty good on that score (and other things), and I’d throw some existentialism of Buddhism into the mix, if you like. Recovery as a philosophical version of wellness that follows experiences like addiction, mental illness, grief, etc.
At the same time, I’m not sure I’d want to make a philosophical awakening a prerequisite of anyone’s recovery.
Thanks, and glad you're finding this useful! Some recovery focused people like to say "it's important to meet people where they are, but not to leave them where they are". I think there's a lot to that and it sounds related to what you're saying. But I also agree, we have to be humble and respectful about what we promise
I am totally with you, sometimes old school approaches seem to work, and that should be a cue to look deeper. I think it's sometimes because the old school approaches provide a vision for recovery. The question "what do you want" falls short on its own when people are defeated, hopeless, resigned, or otherwise don't believe in the possibility of meaningful recovery.
Thank you Carl. This was of immense help to me in my current efforts to rethink practices and programming at the residential treatment centre where I currently work. I'm wondering if you have any reccomondations for a reading list that would be of help in this endeavor? I am relatively new to the field and have come into it by way of lived experience. Sorting through the vast amount of books, papers, thinkers, theories etc. can be an overwhelming task!
I'm really glad to hear that Zachary. A reading list is a great idea! I'll give it some thought and put together something pretty soon. Can you tell me a little more about what would be most helpful? I assume overviews of the field would be good, but also which selected topics are you interested in learning about, what are the questions you are looking to answer or problems you are trying to solve through your reading?
Thank you for being so generous with your time Carl. Perhaps a little bit of context would be helpful. I work at a therapeutic community in Winnipeg, Manitoba. It has been around for 50 plus years and while it has many strengths - people can stay as long as they desire, there are no financial barriers to entry - not much else has changed in a great number of years. I myself entered the program directly from incarceration after being accepted into the bail program. I was later joined there by my partner and young daughter. While my family and countless others have benefited immensely from the program over the years, at present we don't offer much more than a safe, sober environment with a hodgepodge of random seminars that were designed many years ago. So yes, general overviews of the field would be great. I am also interested in learning more about practical applications of some of the big ideas out there. What are some evidence based modalities of treatment and recovery that we could introduce to our residents? How can we better help them to cultivate an individualized pathway to recovery? What practical tools and strategies can we introduce them to? One of our challenges we have is the diversity of lived experience in our community. I dont feel that a one size fits all approach makes much sense. So really I'm interested in anything and everything. I hope that helps, and many thanks again.
Also, I wanted to mention that not long after getting out of prison I went and got a library card. While browsing the shelves I found your book and it was one of the first ones I read early in my recovery journey. Not only did I enjoy it immensely, I believe it probably helped me a great deal too. For a very long time I hated myself and believed there was something uniquely wrong with my mind and behaviors. Your book was one of the things that helped slowly nudge me out of that mindset.
Thank you, Carl - this is super helpful and provides a lot of food for thought. I appreciate seeing these different frameworks and your back of the envelope breakdown resonates with me.
Oh, I love this stuff. Thanks for providing a variety of frameworks I might use to organize my self-improvement endeavors. I´m not entirely sure that my constant focus on goals is "healthy" but it´s fun! One thing I notice is that it´s often hard to categorize particular practices; there´s often overlap. For instance, should I put going for a walk with my partner in the health category (exercise!) or the interpersonal category? Is writing a self-awareness exercise or a craft I´m trying to get better at? And where would I put in going to a yoga class -- spiritual development? physical health? community involvement? Ultimately all this crossover between categories is probably a good thing but the nerd in me would prefer less ambiguous self-help charts.
It´s interesting to think about those areas of flourishing where I´m perenially lacking. For instance, community. I don´t have a lot to put down under this heading. Whether or not that´s a problem I´m not sure. It´s possible that I´d benefit from joining more groups; also possible that this is a category that just isn´t that important to me. Can I be a well-being specialist? I suspect that there are people who focus in on one area -- athletic achievement, meditation, a broad friendship circle -- and that not everybody needs to do everything.
That's a great thought, thanks for writing. I think of these categories as worthy of consideration but not necessary for everyone. Many people consider themselves not at all spiritual, for example.
As a doctor, for example, when doing an assessment I might think about each of these domains as part of the question, "where best to direct our energy to support someone's goals?" If community didn't resonate with someone I wouldn't push it.
I do think people are naturally going to be more inclined toward one or another, and the perfectionist idea of mastering every possible domain of life can be more trouble than it's worth.
From a practical angle I find these activities that cross domains-walk with partner to use your example- are really beneficial because we only have so much time. These “high leverage” activities are a part of the How from my perspective. And also seeing how they are beneficial in multiple domains helps me integrate their worth.
Thanks Eric, great to see you on here. Totally agree, a lot of the cross-domains thinking is meant to direct our time and energy appropriately, and also look for opportunities for creative combination and augmentation.
Just researched Internal Family Systems on Wikipedia. That 2015 is off. So interesting. I am immersed in Pema Chodron, “Comfortable with Uncertainty” I find her more helpful than Steven Hayes, much as I like him!
I’m glad that the Rat Pack is working on more than just “frameworks.” As for “evidence based” and Internal Family Systems, not evidence based. I was a patient of a psychologist in about 2004, a 5 year stint. He labeled me as PTSD based on a violent incident with my youngest son. (I am imagining all kind of negative assessments of my son in a readers mind. Please stop those thoughts. The story is complex. My son was a kind, thoughtful person. A villain in that story is the thinking and beliefs of many treatment providers and groups, twelve step included)
I started writing to different parts of myself. The only label I could come up with was DID. When I heard about Internal Family Systems, the lights went on! Under stress, I believe, that this internal structure, a helpful one for me in usual circumstances, was like Humpty Dumpty, shattered, “all the psychological treatments” couldn’t help me understand myself. I believe the information about internal family systems was in treatment discourse around 2015.
I have been very cursory as a follower of the Rat Pack. I have a goal: start reading this Substack on a regular basis and cultivate a hobby, writing fiction. I subscribe to George Saunders also. He has a great book besides Lincoln in the Bardo. The book is Swimming in a Pond in the Rain.
Just jumping over from psychiatry at the margins, and I’m getting a lot out of the writing and discussion here. I work with specialty courts (“drug courts”), and while I subscribe to what I take to be more modern (individualized, autonomy and motivation focused), I interact with a lot of more old school ideas (confrontational, surrender focused). It’s especially chastening when those old school approaches seem to work. I’m always trying to figure out what vision or visions of recovery I want to offer—or if I want to have one. It seems useful to have something more than “what do YOU want?” But it seems dishonest to start making promises.
The question of recovery v wellness has come up. Intellectually, I want to say something like “recovery is a move towards wellness after an experience of powerlessness.” I think the 12 Steps are pretty good on that score (and other things), and I’d throw some existentialism of Buddhism into the mix, if you like. Recovery as a philosophical version of wellness that follows experiences like addiction, mental illness, grief, etc.
At the same time, I’m not sure I’d want to make a philosophical awakening a prerequisite of anyone’s recovery.
I look forward to seeing where things go here.
Thanks, and glad you're finding this useful! Some recovery focused people like to say "it's important to meet people where they are, but not to leave them where they are". I think there's a lot to that and it sounds related to what you're saying. But I also agree, we have to be humble and respectful about what we promise
I am totally with you, sometimes old school approaches seem to work, and that should be a cue to look deeper. I think it's sometimes because the old school approaches provide a vision for recovery. The question "what do you want" falls short on its own when people are defeated, hopeless, resigned, or otherwise don't believe in the possibility of meaningful recovery.
Thank you Carl. This was of immense help to me in my current efforts to rethink practices and programming at the residential treatment centre where I currently work. I'm wondering if you have any reccomondations for a reading list that would be of help in this endeavor? I am relatively new to the field and have come into it by way of lived experience. Sorting through the vast amount of books, papers, thinkers, theories etc. can be an overwhelming task!
I'm really glad to hear that Zachary. A reading list is a great idea! I'll give it some thought and put together something pretty soon. Can you tell me a little more about what would be most helpful? I assume overviews of the field would be good, but also which selected topics are you interested in learning about, what are the questions you are looking to answer or problems you are trying to solve through your reading?
Thank you for being so generous with your time Carl. Perhaps a little bit of context would be helpful. I work at a therapeutic community in Winnipeg, Manitoba. It has been around for 50 plus years and while it has many strengths - people can stay as long as they desire, there are no financial barriers to entry - not much else has changed in a great number of years. I myself entered the program directly from incarceration after being accepted into the bail program. I was later joined there by my partner and young daughter. While my family and countless others have benefited immensely from the program over the years, at present we don't offer much more than a safe, sober environment with a hodgepodge of random seminars that were designed many years ago. So yes, general overviews of the field would be great. I am also interested in learning more about practical applications of some of the big ideas out there. What are some evidence based modalities of treatment and recovery that we could introduce to our residents? How can we better help them to cultivate an individualized pathway to recovery? What practical tools and strategies can we introduce them to? One of our challenges we have is the diversity of lived experience in our community. I dont feel that a one size fits all approach makes much sense. So really I'm interested in anything and everything. I hope that helps, and many thanks again.
Also, I wanted to mention that not long after getting out of prison I went and got a library card. While browsing the shelves I found your book and it was one of the first ones I read early in my recovery journey. Not only did I enjoy it immensely, I believe it probably helped me a great deal too. For a very long time I hated myself and believed there was something uniquely wrong with my mind and behaviors. Your book was one of the things that helped slowly nudge me out of that mindset.
Comments like these make my day! So glad it was helpful
This is very good context, thanks for this! I'll give it a think and plan a future post about it.
Thank you so much Carl!
Thank you, Carl - this is super helpful and provides a lot of food for thought. I appreciate seeing these different frameworks and your back of the envelope breakdown resonates with me.
Oh, I love this stuff. Thanks for providing a variety of frameworks I might use to organize my self-improvement endeavors. I´m not entirely sure that my constant focus on goals is "healthy" but it´s fun! One thing I notice is that it´s often hard to categorize particular practices; there´s often overlap. For instance, should I put going for a walk with my partner in the health category (exercise!) or the interpersonal category? Is writing a self-awareness exercise or a craft I´m trying to get better at? And where would I put in going to a yoga class -- spiritual development? physical health? community involvement? Ultimately all this crossover between categories is probably a good thing but the nerd in me would prefer less ambiguous self-help charts.
It´s interesting to think about those areas of flourishing where I´m perenially lacking. For instance, community. I don´t have a lot to put down under this heading. Whether or not that´s a problem I´m not sure. It´s possible that I´d benefit from joining more groups; also possible that this is a category that just isn´t that important to me. Can I be a well-being specialist? I suspect that there are people who focus in on one area -- athletic achievement, meditation, a broad friendship circle -- and that not everybody needs to do everything.
That's a great thought, thanks for writing. I think of these categories as worthy of consideration but not necessary for everyone. Many people consider themselves not at all spiritual, for example.
As a doctor, for example, when doing an assessment I might think about each of these domains as part of the question, "where best to direct our energy to support someone's goals?" If community didn't resonate with someone I wouldn't push it.
I do think people are naturally going to be more inclined toward one or another, and the perfectionist idea of mastering every possible domain of life can be more trouble than it's worth.
From a practical angle I find these activities that cross domains-walk with partner to use your example- are really beneficial because we only have so much time. These “high leverage” activities are a part of the How from my perspective. And also seeing how they are beneficial in multiple domains helps me integrate their worth.
Thanks Eric, great to see you on here. Totally agree, a lot of the cross-domains thinking is meant to direct our time and energy appropriately, and also look for opportunities for creative combination and augmentation.
Just researched Internal Family Systems on Wikipedia. That 2015 is off. So interesting. I am immersed in Pema Chodron, “Comfortable with Uncertainty” I find her more helpful than Steven Hayes, much as I like him!
I’m glad that the Rat Pack is working on more than just “frameworks.” As for “evidence based” and Internal Family Systems, not evidence based. I was a patient of a psychologist in about 2004, a 5 year stint. He labeled me as PTSD based on a violent incident with my youngest son. (I am imagining all kind of negative assessments of my son in a readers mind. Please stop those thoughts. The story is complex. My son was a kind, thoughtful person. A villain in that story is the thinking and beliefs of many treatment providers and groups, twelve step included)
I started writing to different parts of myself. The only label I could come up with was DID. When I heard about Internal Family Systems, the lights went on! Under stress, I believe, that this internal structure, a helpful one for me in usual circumstances, was like Humpty Dumpty, shattered, “all the psychological treatments” couldn’t help me understand myself. I believe the information about internal family systems was in treatment discourse around 2015.
I have been very cursory as a follower of the Rat Pack. I have a goal: start reading this Substack on a regular basis and cultivate a hobby, writing fiction. I subscribe to George Saunders also. He has a great book besides Lincoln in the Bardo. The book is Swimming in a Pond in the Rain.