Source: SunSentinel Author: James G. Driscoll, Editorial Writer Pubdate: Monday, 15 Dec 97 Contact: For LTEs we suggest using the form at: http://www.sunsentinel.com/SunServe/letters_editor.htm PROGRAM STRUCTURED TO COAX ADDICTS OUT OF THEIR HABIT An apprehensive addict walks into the Family Institute in Fort Lauderdale, and after filling out a newpatient form, meets psychologist William Grady Ryan for the first time. The addict isn't fully aware of it yet, but if she follows the guidance of Ryan and his associate, Marlene Uchin, there's a good chance she'll emerge eventually from the prolonged train wreck that is addiction. She won't be coddled, but will be helped with understanding, compassion and deep knowledge about addiction and effective ways to deal with it. Ryan will make clear from the start she must attend a selfhelp group Narcotics Anonymous or Alcoholics Anonymous as a vital part of her treatment. Not just occasionally. For the first 90 days, she'll be required to attend a selfhelp meeting every day; after that, less frequently, but regularly. Ryan believes the most effective method of recovery combines psychotherapy treatment with selfhelp groups. He is convinced, as well, it's imperative a patient stop denying addiction, and accept it as a reality. An addict should learn that addiction is a primary relationship between herself and a substance more powerful than anything, which is how Ryan defines it. There's an obsessivecompulsive trait involved, as the addict thinks a lot about doing drugs and then carries out the thought. Addiction clearly is a selfcentered disease. From long experience over a quarter century, Ryan is ready for a wide range of responses from a patient. He insists she first become sober completely stop using drugs and alcohol and that's not always easy. Some patients will argue that if they switch to drinking beer, say, instead of snorting cocaine their drug of choice they'll be all right. Not so. Ryan makes this firm, unalterable point: A recovering addict can never safely take drugs or pick up a drink. Not ever. And the addict will never be ``recovered,'' just ``recovering,'' with the fragility inherent in that word. If a patient keeps on using drugs, Ryan may send her to a detoxification center. Or to residential treatment for a month, sometimes out of Florida. After the patient's brain is no longer marinated with drugs or alcohol, and perhaps after comprehensive psychological testing, Ryan will help her explore her innerspace capsule. Part of that is confronting the low selfesteem common to addicts. ``They think they're bad people,'' says Ryan, ``and we tell them they're not.'' Focusing on behavior patterns the patient may not be aware of, Ryan emphasizes that she can't go back to the people and places where she went wrong. That means avoiding the street corner where she bought coke and staying away from the ``friends'' who did drugs with her. Ryan has been there. A recovering alcoholic, he recalls returning to a familiar bar after two years and being greeted matteroffactly by the regular drinkers. ``They thought I was on a long bathroom break,'' he says. At times during treatment, Ryan and Uchin may meet with a patient's family, perhaps to enlist their help when detoxification or residential treatment is obviously necessary, but the patient resists. Or an employer may be brought into the process if a patient's job is at stake. Ryan's work is heavy lifting, with lives, family relationships and employment on the line. His personal background gives him a special knowledge of what it's like being in the patient's chair, which translates not only into empathy, but the ability to detect a con job. Addicts tend to lie about their behavior. To Ryan, from a treatment viewpoint, it helps to consider substance abuse ``a relatively independent syndrome'' rather than a symptom of underlying conflict. Not all professionals who treat addicts agree with that outlook, which for a long time has been an important aspect of selfhelp groups' approach. The effective professional also should be like a brokenfield runner in football, flexible enough to shift directions to meet the needs of each patient. Rigidity in treatment doesn't work. Not every patient needs therapy, and Ryan is quick to credit the various ``anonymous'' selfhelp groups as being sufficient to modify behavior of many addicts. For those who require therapy, Ryan has devised effective ways to, in many cases, change their lives for the better. It is an admirable undertaking. Copyright © 1997, SunSentinel Company and South Florida Interactive, Inc.