An Example of Drug and Alcohol Treatment

Jerry, a forty-seven-year-old alcoholic-poly-drug abuser with one hundred days of sobriety, was having significant difficulty maintaining his sobriety. The desire to drink and use drugs was constantly on his mind, and he had had three near relapses in the prior two weeks. The following is an excerpt of a Therapeutic Coaching session:

Jerry: “I can’t help it doc. Everything I see makes me think about getting high. I feel so bored and empty. If it weren’t for this constant fear of drinking and using, I wouldn’t be feeling anything at all.”

Jim: “Jerry, it seems as if you are using a tremendous amount of energy in NOT drinking and using. All you seem to be thinking about is not relapsing, and fighting to try to ignore the urge to drink and use.”

Jerry: “Of course! I go to meetings all the time, I never feel safe. I know that if I have another drink or use again, I am going to die.”

Jim: “Jerry, do you remember me talking bout the two-year-old addictive part of you when you were going through the program?”

Jerry: “Yeah, now that you mention it, but I had forgotten all about that. I have been so busy trying not to drink and use, that I guess I forgot a lot of things from the programs.”

Jim: Well Jerry, it is real easy to do, and what is important is to allow yourself to remember now, and to begin to use the tools you have learned now that you remember. Take a moment…here in the safety of my office…to let yourself really feel the urge to drink and use, to really experience what is going on inside. Allow those feelings to float up to an image of the two-year-old Jerry, and just notice how big he seems as you begin to look at him.”

Jerry: “Shit, he seems huge!”

Jim: “Look again Jerry, Allow yourself to see him for the two-year-old he really is. Don’t be confused by the intensity of his tantrum. You need to love him enough to say NO in a caring and respectful way.”

Jerry: “He seems so small now. How can he have so much power? I mean, I really feel out of control and scared so much of the time.”

Jim: “Of course you do Jerry. What is happening inside is that you forgot to parent little Jerry, and so you became him. The adult was able to get you to meetings, but that is as far as he went. Give yourself credit for that much. Celebrate the fact that you have maintained your sobriety. It is natural for a two-year-old to feel overwhelmed when he doesn’t have an adult to take care of him. Is it OK for us to do it in an easier way?”

Jerry: “Sure!”

Jim: “I want you to keep that two-year-old with you every where you go this week. Take him to the meetings with you, take him to work with you, take him with you when you go to the bathroom. I want you to understand he is going to tantrum, and that is fine. What is important is for you to remember that you are a hell of a lot bigger than he is, and can protect him and yourself as you ride out the tantrums.”

Jerry: “I’ve got to remember that he is a little kid.”

Jim: “That’s right Jerry, and the more loving, firm and consistent you can be with him, the easier it will become. He needs to learn that he can trust you to be there, and to keep the limits consistent and predictable. It is also important to begin saying YES to healthy things. Let yourself begin to have some fun with him in between the tantrums.”