Archive for October, 2009

by Tony Foster.

Domestic violence affects over one million people in the United States every year in all kinds of relationships (Rennison & Welchans, 2000). The victims often sustain serious injuries, some even killed. It is estimated that the medical costs of treating patients who are presenting due to undiagnosed domestic violence is $67 million per year (Family Violence Prevention Fund, 2000). In the gay community it is described as the third most severe health problem among gay men, after AIDS and substance abuse. Furthermore, victims of domestic violence were found to have higher rates of depression, hypertension, obesity, sexually transmitted infections and behaviors such as unprotected sex and substance abuse (Houston and McKirnan, 2007). Yet, even the gay community discourages reporting the abuse for fear of bad “public relations” (Mendieta, 1999)

One of the most misunderstood factors in domestic violence is the myth that there is no such thing as abuse in same-sex relationships. The words “battering” and “domestic and family violence” are usually associated with the images of men abusing women. The truth is that the ratio of reported abuse is very similar to that of heterosexual relationships, generally reported at between 25% and 33% (Seelau and Seelau, 2005). Some surveys have shown the rates to be as much as three times higher than those reported by men involved with women (Houston and McKirnan, 2007). However, these are generally accepted as estimates which fly in the face of the fact that the gay community believes most same-sex violence is grossly underreported and that those who do not come forward far outnumber those who do (Skolnik, et al, 2008). This is because of the stigma and denial associated with violence; the gay community doesn’t want the negative attention that comes along with it. Therefore, the abused feel like they’re betraying the community if they report the event (Ristock, 2005).

To make matters worse, the abused person in a gay relationship has the added fear of being “outed” that doesn’t exist in a heterosexual relationship. Add to that the fact that the authorities have a tendency to look the other way when there is evidence of abuse in a same sex relationship (Turrell, 2000). This paper will examine several myths about gay relationships. However, it will concentrate on the unspoken, often ignored, idea that abuse occurs in all types of relationships, even in gay relationships where the stereotype has always been that gay men were “too sensitive” to be abusive. Equally as wrong is the stereotype that the “butch” woman in the relationship is in control and therefore the aggressor in any abusive event (Finnigan and MacAulay, 1996). Additionally, this paper will attempt to make recommendations for therapists and clinicians to do a better, more consistent job in their handling of same-sex domestic abuse.

Let’s begin by using the proper terminology. Domestic abuse in any relationship, but particularly in same-sex relationships, is known as intimate partner violence. The National Coalition of Anti-Violence Programs defines intimate partner violence as “a pattern of behavior where one partner coerces, dominates, and isolates the other to maintain power and control over their partner” (Skolnik, et al, 2008). There is no specific mention of physical violence. Most research indicates that intimate partner violence occurs when there are instances of one or more of the following:

• Abuse which is physical, sexual, emotional, psychological, or involves verbal behavior used to coerce, threaten or humiliate.
• The abuse often occurs and is most dangerous when one partner in the relationship seeks to leave.
• The purpose of the abuse is to maintain control and power over one’s partner.
• The abused partner feels alone, isolated and afraid, and is usually convinced that the abuse is somehow her or his fault, or could have been avoided if she or he knew what to do.
• A pattern of violence or behaviors exists where one seeks to control the thoughts, beliefs, or conduct of their intimate partner, or to punish their partner for resisting their control. This may be seen as physical or sexual violence, or emotional and verbal abuse.
• Abuse often occurs in a cyclical fashion, known as the “cycle of abuse”.

The cycle of abuse is an important factor in the continuation of abuse that occurs in a violent relationship. This model describes three stages: honeymoon, tension- building, and blow-up. As this cycle occurs over and over again it usually increases in frequency and severity.

In the honeymoon stage the victim is likely to see the abusive partner in a positive light at all times, including the discussion of past abusive instances. There is some minimizing and denial on the part of the victim.

In the tension-building stage the victim is often anxious and uncomfortable about the relationship. There is a feeling of “walking on eggshells” by the victim.

In the blow-up stage the victim is focusing on his/her safety. They are afraid to take action for fear that it will provoke the abuser. During this stage, especially if the cycle is repeated many times, the victim is at an increased risk of harm. Most serious injuries occur when the blow-up has occurred many times. Even if there is no physical violence there will be consequences to the victim. The consequences might include the destruction of a precious item, loss of contact with a close friend or family member, or injury. After the blow-up stage the cycle begins again with the honeymoon cycle (Pitt and Dolan-Soto, 2001).

There are distinctions between same-sex intimate partner violence and that which exists in heterosexual relationships. Some of the differences, making it additionally challenging for the abused, are as follows:

• There is often the threat, either spoken or not, that the abuser will “out” the abused to his family, his employer, or his landlord.
• Resources for dealing with same-sex abuse are limited and where they exist are often manned by people who are not properly trained, have sensitivity to the issues, or can properly recognize and address abusive Gay Lesbian Bisexual or Transsexual (GLBT) relationships.
• It is frequently incorrectly assumed that GLBT abuse must be mutual since they are both the same sex. However, there are studies which suggest that establishing a distinction between perpetrator and victim is often hard to do because the roles may change (Stanley, Bartholomew, Taylor, Oram, and Landolt, 2006).
• Using the limited resources might require “coming out”, which is a major life decision for a GLBT.
• There is concern about telling heterosexual social workers about abuse at a shelter because it might reinforce another myth, that the relationships are “abnormal”.
• The abuser often uses racism, homophobia, transphobia, classism, ableism, immigration, and HIV status, even the abuser’s own vulnerabilities, to inflict harm (Skolnik, et al, 2008).

Some of the other myths which are perpetrated regarding same-sex relationships are:

1. Only straight women get battered. Men are not victims of domestic violence, and women never batter;
2. Domestic violence is more common in heterosexual relationships that it is in same-sex relationships. Every survey I found has shown very similar percentages;
3. It really isn’t violence when a same-sex-couple fights. It’s just a lover’s quarrel, a fair fight among equals;
4. It really isn’t violence when gay men fight. It is boys being boys. A man should be able to defend himself.
5. The batterer is always bigger, stronger, more “butch”. Victims will always be smaller, weaker, more feminine.
6. Lesbian and Gay domestic violence is sexual behavior, a version of S & M. The victim actually likes it.
7. The law does not and will not protect victims of same-sex domestic violence.
8. It is easier for lesbian or gay victims of domestic violence to leave the abusive relationship than it is for heterosexual battered women who are married (Domestic Violence in Same-Sex Relationships).

RESEARCH REFERENCES

Brown, M. J., and Groscup, J. (2008). Perceptions of Same-sex Domestic Violence Among Crisis Center Staff Journal of Family Violence, Vol. 24: 87-93.

Burke, T. W., and Owen, S. S. (2006). Same-Sex Domestic Violence: Is anyone listening? The Gay & Lesbian Review Worldwide, XIII (1), 6.

Davenport, B., (2008). Hurts too bad-domestic violence in same sex relationships. Gay & Lesbian Times, May 1, 2008: 36-38

Devine, J., (2008). Domestic Violence in Gay Relationships. BQ Online Magazine, August 13, 2008. Available on the Internet at http://wvyrw.bqueer.com/article/DomesticViolence-in-Gav-Relationships-a16.html.

Family Violence Prevention Fund, Health Care Response to Domestic Violence Fact Sheet, (2000). Available on the Internet at http://www.fvpf.org/health/facts.html.

Finnigan, B., and MacAulay, D. (1996). Abuse in Same-Sex Relationships. Violence in Same-Sex Relationship Information Project, (1996).

Houston, E., and McKirnan, D.J., (2007) Intimate Partner Abuse among Gay and Bisexual Men: Risk Correlates and Health Outcomes. Journal of Urban Health: Bulletin of the New York Academy of Medicine, Vol. 84, No. 5, 2007: 681-690.

Mendieta, M., (1999) Hidden Bruises: A new report exposes the unspoken problem of domestic violence among gays and lesbians. The Advocate, Issue 799: p. 24.

New Beginnings, A Women’s Crisis Center, Same Sex Partner Abuse, (2009). Available on the Internet at http:/www.newbeginningsnh.org/gaylesbianpartner.html.

Pitt, E., (2000), Domestic Violence in Gay and Lesbian Relationships. Journal of the Gay and Lesbian Medical Association, Vol. 4, No. 4, 2000: 195-196.

Pitt, E., and Dolan-Soto, D., (2001). Clinical Considerations in Working with Victims of Same-Sex Domestic Violence. Journal of the Gay and Lesbian Medical Association, Vol. 5, No. 4, December 2001: 163-169.

Rennison, C.M., and Welchans, S. (2000). Intimate partner violence. Washington, D.C.: Bureau of Justice Statistics.\

Ristock, J., and Timbang, N., (2005). Relationship Violence in Lesbian/Gay/Bisexual/Transgender/Queer (LGBTQ) Communities ó Moving Beyond a Gender- Based Framework. Violence Against Women Online Resources. July 2005: 1-19.

Seelau, S.M. and Seelau, E.P., (2005). Gender-Role Stereotypes and Perceptions of Heterosexual, Gay and Lesbian Domestic Violence. Journal of Family Violence, Vol. 20, No. 6, 2005: 363-371.

Skolnik, A.A., et al, Lesbian, Gay, Bisexual and Transgender Domestic Violence in the United States in 2007, National Coalition of Anti-Violence Programs, (2008).

Stanley, J.L., Bartholomew, K., Taylor, T., Oram, D., and Landolt, M., (2006) Intimate Violence in Same-Sex Relationships. Journal of Family Violence, Vol. 21, No. 1, 2006: 31-41.

Turrell, S.C. (2000). A Descriptive Analysis of Same-Sex Relationship Violence for a Diverse Sample. Journal of Family Violence, Vol. 15, No. 3, 2000: 281-293.

Domestic Violence in Same-Sex Relationships. Available on the Internet at http://www.aardvarc.org/dv/p-samesex.html

Domestic Violence in Fay, Lesbian, and Bisexual Relationships. Available on the Internet at http://www.lambda.org/DV background.html

One of the most heart breaking things to deal with is a Xanax addicted family member. Xanax side effects can vary amongst persons but include the following:

• Difficulty concentrating
• Floated or disconnected sensation
• Depressed heartbeat
• Depressed breathing
• Excessive sleep and sleepiness
• Mental confusion
• Memory loss

When a family member is addicted to Xanax it is hard for them to just stop without help as the withdrawal symptoms can be excruciating. They may experience rapid heartbeat, shaky hands, insomnia, sweating, irritability, anxiety and agitation. Family members while they want to help members with a Xanax addiction often find themselves feeling overwhelmed and helpless and some even give up. You can help your family member beat their Xanax addiction but it is important to continue to show love and support for your Xanax addicted family member. Xanax addicts who have no support system are twice as likely to continue their abuse as in their mind they have nothing to live for. Always encourage them to get help and be patient with him/her. Consider doing an intervention with a certified and getting them enrolled in a Xanax treatment program.

The Beachcomber treatment center in Delray Beach, Florida offers a unique targeted program for Xanax addiction and other prescription drug addiction. The program includes individualized assessments and treatment plans to meet specific needs following detoxification. Our Center has specialized in addiction treatment since 1976 and is the oldest operating residential program in Florida.

To speak to a certified a certified Xanax addiction counselor click here.

By Tony Foster

Although I went to treatment for alcoholism three times in a seven month period it was only the third time that I went by choice. The first time I went was at the behest of my family along with a Baker Act. As you might imagine, I wasn’t excited about being in treatment and giving up alcohol. Consequently, I did my twenty-eight days and stayed sober exactly five days.

Soon after that my wife went to court to have me committed under the Marchman Act. A judge signed off that I was a danger to society and myself, and off I went to treatment again. This time I was even less excited about investing a month of my life into doing something I didn’t want to do. I decided that since I was a grown man nobody was going to tell me when I could or couldn’t drink. I drank on the 28th day on the way home from treatment. Imagine my surprise when I got home and found my house completely empty, except for an easy chair and a television. Believe it or not, I thought I had won the lottery. Now I could drink with impunity. No wife or kid around to stop me. That lasted about six weeks.

During those six weeks the only thing I ate was one bag of M & Ms per day that my wife brought me. She hadn’t completely given up on me, she just couldn’t live with me like that. In any case, during the six weeks I lost sixty pounds. Then one day she came over and out of the blue I said to her “I want to stop drinking”, “I want to change my life”. What I didn’t know then was that I suddenly had something that I never had before, a desire to stop drinking. Alcoholics Anonymous says that the only requirement for membership is a desire to stop drinking. I finally qualified. I said to my wife, “I’m going to go to treatment and do everything they tell me to do”. I opened the phone book and found the Beachcomber, an alcohol and drug treatment facility in Delray Beach. That decision changed my life in more ways than I can count. It literally saved me from a painful, premature death.

My start at the Beachcomber was inauspicious, at best. On the appointed day of my intake my wife drove me there at about 8:30 in the morning. I had been drinking until 4 AM. Joe, the owner, did not want me to stay because he thought I needed detox. My wife begged him to let me stay and capped her pleading and crying with “we need a miracle”. That’s what the Beachcomber became for me, a miracle.

Like many treatment facilities of its kind the Beachcomber uses a twelve step model to help patients get and stay sober. But they do much more than that. Alcoholics Anonymous tells us that drinking is but a symptom of underlying issues that are going on. The Beachcomber focuses on that over a twenty-eight day program. However, it’s how they do it that’s so unique. First, they only have sixteen beds so they never have more than sixteen patients. For these sixteen patients they have five therapists. I doubt you’ll find that kind of ratio anywhere else in the country. They also have a full and a part time chef. Like most other new patients I showed up undernourished and with terrible (or no) eating habits. The chefs took care of that. But besides the food and the therapists it was what I was taught that really helped me when I got out.

I was taught that I was feeling a lot of guilt and shame for what my life had become and how I had squandered a family and my own potential. I learned that there is a grieving process to quitting drinking and that I had to now feel things that in the past I would always drown with vodka. I had to learn how to live my life one day at a time without a drink. But I believe the reason I am sober today is that I learned “Toothbrush Therapy”.

Toothbrush Therapy is a method taught at the Beachcomber which gives one a daily routine that helps a recovering alcoholic or drug addict stay sober. I can still remember Trey, a Beachcomber therapist, saying “if you follow the simple directions and do these five things every day I guarantee you, you will never drink again”. The first time I heard that I was beside myself. You’ve got to be kidding, I thought. In fact, it was early in treatment that I heard it the first time and like a good alcoholic I was going to prove Trey wrong. Well guess what, not only was I wrong, I’ve been doing it now for nearly six and a half years and I haven’t had a drink yet.

Toothbrush Therapy is named because it is designed in a way that it is used as you would brushing your teeth. You get in a routine for personal grooming and such and Toothbrush Therapy establishes a routine. It takes into account that alcoholics and drug addicts are creatures of habit, usually bad ones. But if we really want to be sober Toothbrush Therapy makes it pretty simple. You just have to do it every day. Does that seem like a lot? Well, I drank every day from the moment I woke up until I passed out. I was either buying alcohol or consuming it every waking hour. Toothbrush Therapy can be done in as little as one hour and forty-five minutes per day. Now if you really want to stay sober that seems like a very small requirement to me. If you can’t invest that much time in your sobriety and saving your life then you really don’t want to be sober. I decided to condense Toothbrush Therapy to one sheet that I could refer to all the time. This made it even simpler. In short, I pray at the beginning and end of each day. I also meditate every day. I follow that up with reading four pages of AA literature. Then I go to a meeting every day. I also have a support group of recovering people who I talk to every day. Finally, at the end of every day I write a gratitude list in the manner of a letter to God (my higher power). In the letter I thank him for five things in my life which I’m grateful for. That’s the end of Toothbrush Therapy for that day. As Trey says, “follow the simple directions” and it works.

Taking a personal inventory is good common sense and most people would agree it’s a habit worth cultivating.  Many have found a daily journal or diary equally rewarding as life unfolds.  It can be a way of avoiding the mistakes of our past.  The 12-Step programs for Alcoholics Anonymous and Narcotics Anonymous suggest “we make a searching and fearless moral inventory” as we begin our recovery program.  Then later an “inventory” is encouraged as new challenges and accomplishments unfold.

Writing our thoughts and feelings down, particularly how they relate to gratitude, is an invaluable way of reaffirming things that have come through conscious contact with a higher power and a program that’s truly working.  If and when we may be experiencing mild depression or anxiety, feelings of boredom, or frustration we purposefully write out things we’ve done for our own betterment and some of the ills we’ve managed to overcome by personal effort.

If we find it difficult to begin we can start with the alphabet.  We can feel good about animal pets, air that’s clean and fresh or even a bright apple on the kitchen table.  As we move on to b we find our attention diverted from uncomfortable or negative matters to more positive prospects and accomplishments.  Developing the “attitude of gratitude” has long been a staple of AA/NA groups and often a topic for discussion at meetings.

A gratitude list is best done on a nightly basis and its value is underscored by ways the events of the day have worked toward recovery.  An added benefit of a nightly listing is how it identifies things of value to us and how those items are forming a solid pattern in our route to recovery.  The Good and the Bad leap out to be marked and remembered.

In this respect some alcoholics and addicts have found daily journals most helpful.  In this way we can describe troubling feelings or incidents that have arisen.

When reviewed over time solutions to problems can be applied in many ways and the maxim of “Think” will soon be incorporated in daily living.  On paper events and responses take form and we see situations from a new perspective.  We can, perhaps, better discern actions to be taken in the future.  Writing can help us identify the assets and liabilities that help or hurt our recovery.  Journaling can prove a valuable means of identifying and expressing our feelings in a safe and healthy way.  They might be a first step to sharing those feelings with a therapist, sponsor or friend.  Writing things down helps untangle thoughts and counters self-defeating ideas with alternatives that have proven themselves in prior application.

The often repeated saying “those who forget the lessons of history are doomed to repeat them” is a rather basic truth.  It can apply to individuals, their choice of friends, their conduct together and their levels of maturity.  In most instances alcoholism and addiction are self-acquired illnesses.  They started with simple exposure and through a process of frequency blossomed into habit and dependency.  In that process, however most built a social environment that was part of the dependency.  Drinking “buddies” merged with local bars or clubs and a series of “history lessons” began to unfold.  When treatment begins a review of those lessons takes place in a different context but very soon we detect how Good and Bad come into play with alcoholism and addiction.

As treatment leads to recovery then to sober living, systems abound to remind us of routes to follow.  Aftercare planning can call for residency in a sober-house, might also include periods in outpatient groups and most often, 12-Step meetings are made a part of the process.  It is all geared to change…keyed to new environments…aimed at immediate adjustments in social behavior.  The bottom line is: Dependency on mood altering substances has made a shambles of past history and some very strong lessons have been given.  Don’t forget those lessons learned…they are your history both good and badThe often repeated saying that those who forget the lessons of history are doomed to repeat them has a lot of truth in it!

Experience has clearly proven the value of a solid support network in recovery from alcohol or drug addiction.  For all those involved in programs of recovery nothing is more important than open exchange of information among those sharing in the challenges of substance abuse.  Discussions of life’s daily problems, conflict in feelings that sometimes erupt and “just letting it all out” are common bonds that must be shared.

Those engaged in recovery as members of A.A. or N.A. need to reach out to others and in consequence be open to exchanges in every way possible.  The old adage: “I’d rather do it myself,” is a dangerous path to follow when drug or alcohol dependency is the topic.  Long term recovery improves through working the program with others.  Being part of a “fellowship” helps keep members on course and its very structure is built on the concept of free and open discussion.   “Unmanageable and powerless” conditions in living can’t be tolerated over long periods and knowing others have regained control is critical.  How they achieved that goal is even more important and communication is the key ingredient!

Included in the communication mix are telephones and personal computers.  They are tools which allow us to reach out, ask for help and extend help to others.  They also provide immediate ways of handling daily confrontations, feelings of uncertainty and unexpected painful events that come and go.  These devices can be regarded as the AA or NA meeting place between contacts with sponsor or home group.  Reaching out to others allows us to break out of the isolation so often a symptom of addictions.

One very popular tool is the phone list.  These can be set up through meeting contacts or frequently such lists are available through treatment centers and AA/NA regional offices. Such lists are, of course, a natural way of acquiring new friends and building a new life.

It also pays to have a range of numbers to call since “getting through” can be a matter of vital importance to anyone who is just getting situated in a new environment.  It’s good to have “professional ties” particularly if one is recently out of treatment and the list might include a therapist or counselor that’s been particularly helpful and interested.  Doctors and therapists may be very busy but all are concerned with our well-being and appreciate contact with former clients or patients.

The telephone has proven a lifeline for countless recovering addicts and alcoholics. One recovering person taling with another has proven time and time again to be powerful in preventing the first drink or drug.  The secret is to make the call when the problem starts to present itself.  Rejection or a refusal to help can be avoided by clearing contacts in advance.  If a friend is prepared for possible calls and this is promptly established then an emergency will surely be given full attention. Keeping in touch by phone or computer are established traditions in 12-step programs…they are vital links between members.

The Internet is also a vital recovery tool.  General information is available on many web sites and personal support can come promptly with instant messaging and chat programs among new friends. By going to meetings, using the phone and participating in social events members achieve strong support networks.  Soon members begin to trust and can rely on feedback to maintain their programs.  There is no substitute for regular social contact and it’s why group meetings are so critically important. We communicate!

Nothing’s so bad a drink or drug won’t make it worse. First reach out to a friend in your program.

Beginning with the “Big Book,” Alcoholics Anonymous, a solid foundation for comprehensive treatment was published in 1939 and has undergone some editing and relatively minor changes into its Fourth Edition.  The book, most often referred to by A.A. members as “The Big Book,” described a twelve-step program involving admission of powerlessness over alcohol, moral inventory, complete and direct restitution to those harmed, and asking for direction and guidance, from a higher power.

Essential to this process was the idea that the higher power be “of one’s own understanding.” In 1941, book sales and membership increased after interviews on American radio and favorable articles in US magazines, particularly by Jack Alexander in The Saturday Evening Post. Soon after the General Service Office of A.A. initiated a series of booklets explaining various aspects of the program that evolves to the present.

Reading recovery literature helps members understand and reinforce the many facets to A.A.  The written materials focus on recovery and guide readers away from cravings, restlesness and boredom. They also aid in providing solutions to daily challenges after a program of abstinance begins to take hold.  Many A.A. and Narcotics Anonymous members find that when read on a daily basis, the program literature further reinforces recovery and continues to bring new meaning to the Twelve Steps.

A.A, World Service Office recommends the following books for establishing a solid basis in recovery.  They have been published in English, Spanish and French. They are:

Alcoholics Anonymous, (The Big Book) and The Twelve Steps and Twelve Traditions of Alcoholics Anonymous. In addition, a wide range of topical pamphlets is available on request and may also be obtained though local A.A. groups and regional offices.

For those who are seeking a broader range of written information of Alcoholism and Addiction the Internet provides thousands of references.  If however, the individual is concerned about possible abuse or alcoholic beverages or chemical substances, direct contact with treatment specialists, counselors, or referral agencies is encouraged.