I logged in to my e-mail tonight for the first time in a busy few days, capping a busy few weeks in which we’ve done everything from smash up my car (we are all fine, but it had to make a trip to the body shop to render it safely drivable again) to visit the ER (totally unrelated to the smashing of the car, but again everyone is fine) to host a party for my daughter’s entire first grade class. If I could afford to go to a body shop for humans (otherwise known as a spa, I believe), I’d…

It’s not the first time it’s happened, and won’t be the last.

I get a call from a family physician. Do I want a really tough case? Well no, not really, unless there’s really decent compensation. And there is, so I take it.

(I’ve changed the real details) A VERY depressed man in his late fifties, out of work for two years, he says. That’s a bad sign right there. Ex-addict.

So not unusual, I tell the doctor. Problem is, of course, that chronic depression tends to end with suicide in the sixties for guys like this. Is he using now? The doctor…

I know I wrote about it before, but there’s so much to say on this one. There’s nothing like the alcoholic family that happens to be fun. How often do you hear about that?

The Set Up

It’s not uncommon for a therapist to find couples marrying people from families very different from their own. I tend to like treating these couples, especially when one of the partners is an alcoholic who has married a sober person precisely because he or she knows that sober is better, that this sober person is “good” for him.

(We’ll use “he” – could just…

Here’s what can and will happen in therapy (and therapy is a microcosm, a miniature world, so some of us like it).  So here’s what can happen in therapy when the doctor puts a person in charge of his or her own drinking and that person wants to be in charge, believes it’s possible, really, to control it— when it probably isn’t.

Let’s take a marital therapy case.  The sober spouse, make it a she, is the one who doesn’t drink to excess or drink at all.  Someone like me, a therapist tells her, “Do not count his drinks. He’ll monitor his own drinking. Let…

Family therapists and addictions therapists tend to part ways when it comes to whether or not to cut off, in the name of not enabling, the “sick” member of the family, the one who steals the silverware to pay for the cocaine, the alcohol, the heroin.  Pick your substance, none of them are free.

Not that we’re naive.  We understand that an addict will do anything to get substances, and will exploit the family, in all kinds of ways, as a coping strategy under stress.  Object?  Get drugs.  Drug seeking. 

But family therapists like to keep the door cracked, the lines of…