The Elephant in the purple room

Having worked with a number of recovery communities and services across the U.K over the last decade, it still surprises me how reliant we have become on volunteers. Local authority budgets have been drastically cut in recent years and commissioned treatment provider caseloads in many cases are at unmanageable levels, with recovery workers firefighting complex cases or looking for quick discharges of others with varying levels of ‘sobriety’, it is perhaps no wonder that the integration of volunteer roles has gathered pace. I have visited services with volunteers on reception, running groups, mentoring, providing needle exchange services, doing home visits, and many other roles that were previously paid positions. Whilst this is undoubtedly great to see, and there are clear benefits to both the individual and service as a whole when you treat people as assets rather than just ‘service users’, I am frequently met with frustrations from volunteers, some of which i will attempt to articulate here.

The 2015 UK Life in Recovery survey found that those in recovery volunteer for local services at twice the rate of the general public. ‘we only keep what we have, by giving it away’ is the mantra.

Are service providers over reliant on volunteers? Do those volunteers receive the support and training they need and deserve?

We are frequently reminded, as people in recovery that we should be grateful, and how much ‘giving back’ supports our own wellbeing and recovery. These things are indisputable, I frequently do my own gratitude lists and meditations, as well as volunteer where I can, and I certainly wouldn’t have had a career in substance use without volunteer peer mentoring for my local service at the start of my journey. When I got my first paid position for a local treatment provider I had been volunteering for 18 months, had 27p on the electric meter and was under a sanction from the job centre for missing an appointment while volunteering. I was fortunate to have managers that believed in me, and be given the opportunity to create a job position where there wasn’t one before. That afforded me a pathway back into meaningful employment.

The elephant in the room however is the increasing pressure placed on volunteers in early recovery, and the lack of meaningful support received in many cases. Early recovery as defined by William White is anything under 12 months. Sometimes this period is referred to as the pink fluffy cloud of recovery, often this is the best life has ever been, we are substance free and we start to appreciate life and notice the small things. We want to give back and carry the message that we do recover.

We all love to hear success stories, from despair to hope. It gives us a warm feeling that recovery is possible and helps those earlier in their journey to identify. It is undoubtedly why many of us do what we do. Change is a beautiful thing.

Whilst there is undoubtedly lots of value in sharing our story, to celebrate change, inspire hope and promote visible recovery in our communities, I am often left wondering what support or guidance these brave individuals have in doing so, and also what happens when, as in many cases they serve their purpose, eventually lose their spark, or relapse. We all know that aftercare provision in the UK is in many cases woefully inadequate STILL. There is also an inherent stigma to re presenting at a treatment provider for a volunteer after a relapse. After being placed on a pedestal, overcoming those feelings of shame can be a real barrier. Does the organisation have a relapse policy, and is this equitable and supportive?

Services can be very quick to get their new successes to share their story and get them involved with volunteering. (some would say to evidence their services’ efficacy for future commissioning bids and to tick a ‘service user involvement’ box).

With record numbers of drug related deaths, fewer people entering treatment for alcohol use, and fewer successful exits (whatever successful means in reality) according to PHE statistics, the role of a peer worker is now more important than ever, but it should not compromise your personal recovery.

So what support do we really give these volunteer superstars managing receptions, running groups, facilitating access to mutual aid, mentoring, and generally making working life easier for paid staff and services across the UK that receive millions in contracts to provide services.?

Often, in my experience it is nothing more than inhouse or online training around safeguarding, confidentiality and a DBS to tick the boxes for the provider. I recognise that in the postcode lottery of UK service provision there are areas of really good practice with some great training options including accredited courses and regular supervisions, as well as pathways back into employment, however in my experience this is more the exception than the norm.

So whilst I agree that this recent shift towards enabling those in recovery to empower themselves through volunteering is a positive one on the whole, it must also be balanced with adequate resources and support for them, as well as recognition that their individual recovery is paramount. Volunteering should never be detrimental to personal recovery. Volunteers are more than just free labour, and volunteers should be compensated for the time they give freely.

Whether they are called, recovery champions, peer mentors, peer support workers or volunteers the important roles these individuals play deserve more resources, support and respect than is currently given in many areas. Particularly if they are integral to the delivery of a commissioned service. There is no greater resource than time, and these individuals give theirs freely, the least we could do is give them the skills and support they deserve to;

a) fulfil their role responsibilities to the best of their ability b) build their skills for the future c) have proper supervision d) feel like a valued and respected member of the team

Have local services in your area changed their mindset from ‘fixing and treating’ individuals in recent years to a more person centred community asset based approach? Does your local provider actually provide meaningful volunteer opportunities, as well as adequate support, training and a pathway back into employment? I would love to hear of your lived experiences. Feel free to drop me a confidential message to carlozuccaro@hotmail.co.uk.

Dithering dogma…!

As UK pubs reopened to a mixed response, after the last three months of isolation Brits still seemingly still have a thirst on and aren’t too fussed about distancing.

With news articles declaring consumption has risen during lock-down, and some early studies also looking at potential increases it may be a good time to reflect on our choices. It has undoubtedly been a difficult period, particularly for many of our dependent drinkers, and the lure of getting back out there ‘connecting with friends’ or ‘disconnecting from current reality’. I’ve noticed it both on my social media timelines with friends and family’s daytime drinking patterns, and at work with those i support. One of the biggest protective factors for many was connection, and we have long stressed the importance of this as part of the 5 ways to wellbeing. So as social isolation has grown, as seen in Dr Alexanders rat park experiments of the 70s addictive behaviour invariably escalates.

So what is out there now if i want to get help?

There is of course your local treatment provider commissioned by your local authority, who can put you in touch with all local community assets. A quick online search should find the current one, after initially stopping seeing people face to face many are now opening their doors again. I know many people that simply will not engage with these services due to barriers, either real or perceived varying from stigma to a previous bad experience. There are also mutual aid meetings such as 12 step fellowships like AA or NA that are avidly promoted by GP’s and other public services. Some barriers to engaging with these groups can be the perceived ‘GOD issue’, the ‘powerlessness talk’, the ‘drunkalogues’ or just the perceived monotony of perpetual meetings. Alternatively there is SMART; barriers to engagement – over reliance on confusing concepts or acronyms, lack of community, and ‘recovery know it all’s’. You will often hear the phrase within the recovery community “take what you like and leave the rest” and that is generally the way to go. Whatever you decide do it with an open mind and positive intention. There are some excellent parts that make up the whole and can act as helpful recovery capital to support your goals.

So what about the large majority of those over reliant on substances that find the barriers to engaging with treatment providers or mutual aid too much or too stigmatising?

Recent PHE figures [1][2] before the pandemic also showed disturbing trends of fewer alcohol dependent people engaging with treatment services. Over the last few years we have also seen record numbers of drug related deaths across the UK. It is clear something is not working for many, as services have also faced drastic cuts to their commissioned treatment budgets repeatedly in recent years. The sector is asked to do more with less, but at what cost?

Having worked in “recovery services” of various guises over the last 9 years, and as a person who had a serious substance misuse problem/substance use disorder/addict/person in recovery/recovered* (*delete as appropriate today) I now find myself walking away from the sector i was once passionate about, recently made redundant and disillusioned at current service provision across most of the UK. Having traveled a lot for work i have been fortunate to see some fantastic practice in some areas, however the very nature of commissioning has led to a postcode lottery and dramatic variance in recovery ‘choices’. One thing i have learned in my time working in the sector is that there is no one size fits all approach to recovery, and my view is that recovery should be self directed and defined by the individual. Complete abstinence can be seen as a barrier to entering treatment, and perpetuate the shame following a lapse/relapse. The term recovery itself has become somewhat of an abstract cliche, and people in early recovery are often paraded out to prove a service’s outcomes and to add value to the service’s ever dwindling pot of money, as cuts continue to bite, with very little ongoing support. Volunteers are now finding themselves increasingly on the front line.

“It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. ( Bill Wilson, 1965/1988, p. 333)

Disclaimer, as i know there is an almost tribal response to perceived criticism of ones ‘recovery pathway’ so I will say, i have spent time with various recovery programmes and fellowships over the years, i have sponsored ‘addicts’, chaired and facilitated meetings and repeated many of the dogmatic well rehearsed mantras. I have also bitten my tongue on a number of occasions in order to be diplomatic and not rock the recovery boat, however in my view services and commissioners should and can do better. The statistics are quite clearly showing that the existing model(s) are not working for many.

Dogma has had a stranglehold on treatment for people who use substances since treatment was conceived for ‘treating’ the feckless, right through the temperance movement and into the dominant philosophy of recent times being the 12 step approach, and abstinence being the “only way”. This is manifest still today in funding streams and also in rehabs, as well as local service providers.

As such it is good to see the rise of the moderation/ mindful drinking movement with Club soda putting on mindful drinking festivals (pre corona) and engaging people from across the spectrum, and hopefully more will follow suit and consider new models and ways to build community and a society that does not need to rely on substances or treatment in the way we currently do. Invariably we use substances for Fear or fun, both are short term rewards, but extremely gratifying. Our reliance on substances as an emotional crutch means may of us are floating through life like a carrier bag in the wind. The way out of my addiction was finding a purpose i was passionate about. I will be eternally grateful to my mentors that gave me the opportunity to make it happen, and will continue to support others in defining their own recovery goals without judgement or dogma.

Giving back is an important turning point in many peoples recovery journey (After mentoring i created a small community group to support individuals in my own community with the limited knowledge and resources we had at the time) however the biggest factor in me sustaining my own recovery was challenging my own limiting beliefs and feeling empowered enough to pursue my own personal growth, until then I was just ‘white knuckling it’ and going through the motions.

Change needn’t be difficult, only resistance to it is (to paraphrase the Buddha). Find something or someone that inspires you to be the best version of yourself and apply yourself wholeheartedly, you don’t need to have all the answers. There is no quick fix, and those that are pave a road to ruin. The future is yours. The future is now. 💜

Extra value deals

What makes thousands of people turn out worldwide to protest in the middle of a global pandemic, and what does this tell us about their values ?

Throughout history protests have acted as the catalyst for change and have shaped the world we live in today, from the Suffragettes, Civil rights movement, Stonewall, Labour movements and so many others. There is typically some commentary on ‘legitimate’ forms of protest and acceptable levels of civil disobedience, but many of the changes we now take for granted simply would not have happened solely by banner waving. After the killing of another unarmed black man in the U.S by police protests erupted worldwide, and in the aftermath there was outrage by some at the toppling of a statue at one such demonstration in the U.K. This week also saw some of those claiming to want to “protect the statues” urinating next to memorials, giving the nazi salute and scuffling with police, seemingly conflicting with their projected values.

This was never intended to be a political blog, however as ive turned 40 this week i’m in a reflective mood and have been considering how my own values have changed in recent years. My days of direct action may be over, however i stand in solidarity with those fighting injustices in their own lives. Legality does not equal morality. – Naegeli’s law.

Although clearly i’m no behavioural psychologist i’ve always had a fascination with human behaviour, particularly my own. So what makes us do the things we do?

As well as our basic needs, it is ultimately our values and beliefs that drive our behaviours, whether we are aware of it consciously or not. Many people float through life from one crisis or emotional response to the next without really considering why they feel or act the way they do.

Intrinsically linked to our beliefs, our values are generally the things we view as most important to us, like honesty, justice or freedom. Sometimes these are grouped together with terms such as ‘family values’, ‘national values’ or ‘religious values’.

Values are not fixed and should be reflected on and adjusted as we grow and develop as part of the human experience, but being aware of them is a necessary first step.

When we connect with our values to make decisions, we make a deliberate choice to focus on what is important to us. We are able to engage with the world more intentionally, and lead a more fulfilling life.

I often work with volunteers to help them identify their core values and beliefs. We look at how this impacts on behaviours and the things we view as important. Being aware of our values and recognising how our beliefs affect our behaviour can act as motivation to strive to be the best versions of ourselves. I love values based work because when we genuinely connect with our values and understand how our internal world truly affects us in the ‘real world’ it can be transformational, and bring about long term behavioural change.

So what happens when our own values don’t align with our current situation, or our needs, or even general convenience? Whether that is a relationship, employment or general life. What level of flexibility can we apply to our values, and how do we reconcile these inconsistencies?

Honesty, for example is a commonly stated personal value, but not everyone is as honest as might be desired, and we may too frequently find ourselves being selectively honest. Although values are essentially aspirational and act as a guide, if they are not consciously engaged with or applied to everything that we do, what use are they other than to project a vision of how we want to be seen?

Do you know what your personal values truly are and do you live your life in line with them ?

“One reason we roll our eyes when people start talking about values is that everyone talks a big values game but very few people actually practice one. It can be infuriating, and it’s not just individuals who fall short of the talk. In our experience, only about 10 percent of organizations have operationalized their values into teachable and observable behaviors that are used to train their employees and hold people accountable.” Brené Brown – Dare to Lead

Does your organisation truly embody its own values or are they winging it with morality?

Just because an organisation picks a few buzzwords like ‘inclusive’ or ‘non judgmental’ and puts them at the top of their branded stationery does not mean that it embodies those values. So what is the point of espousing such values if we or our organisation do not truly practice them in our affairs? A commodification of morality perhaps, package wrapped and branded to appeal to others rather than a belief system that truly drives change, and what deals do we make compromising our own values for those of an organisation, or a nation, or a tribe?

If you have ever faced redundancy, “organisational restructuring”, or tendering you may have had some conflict between your own values and those of ‘the board’ who make all the decisions. You may have felt that the board had an agenda, or were walking a fine line with legality. You may have felt undervalued, unappreciated, dis-empowered, overworked or just been at a crossroads. I can wholly relate to those feelings, and find myself at somewhat of a crossroads here currently in terms of my own employment.

If we highly value our basic needs of financial security we may stay in a job that is perhaps no longer fulfilling, or we may be asked to compromise some of our own personal values or standards for another paycheck. Is this a deal we are willing to make?

If we value equality or justice more highly than a statue’s right to exist and have exhausted other options, that may drive behaviour, particularly if a belief in the justice system makes an individual value state justice less, based on personal experience. If we value national pride higher than equality for example and believe some humans deserve more rights than others then this undoubtedly shows up in our values system and behaviours.

Practicing unconditional acceptance as a basic strategy to counter general unhelpful beliefs is something we can all do to help manage some of our emotions. Reminding ourselves ‘life is not always fair’ and ‘people are not always virtuous.’ At times however more direct action is required, but which of our values we are willing to trade off, is of course ultimately a matter of personal choice.

In some of my most challenging moments in recent years I have referred to ancient philosophy for guidance. Epictetus, who was born a Roman slave, wrote often about living a virtuous and joyful life, despite the challenges of his day and i find reassurance in his words. What would the Stoics however think of the modern notion of ‘values‘ and the flexibility to which they are often applied and commodified. Virtues are defined as ‘a consistently applied and habitual practice’ and the stoics valued living a virtuous life above all else. https://dailystoic.com/4-stoic-virtues/

So, In these uncertain times I reaffirm to myself daily; ‘Rather than floating through life I will act with intent, striving for personal excellence in the things within my control, and aligning myself with my core values. I will engage with other humans virtuously and compassionately, and through this practice I will lead a more enriching and fulfilling life.’

💜🖤💜

Home working rules, right?

Millions of brits have got their wish and are now home working in the wake of this Corona virus pandemic. Online meetings have become the norm and contact with other humans is limited. Is there any way to manage this experience so it doesn’t feel quite so bizarre, and still maintain good mental health?

In the past whenever I explained my role as SMART Recovery National coordinator to friends who are front line recovery workers the reply is mostly the same, ‘must be nice to be out the office’…
I remember my days as a recovery worker, of excessive caseloads, data entry, risk management and trying to work out who used your milk out the communal fridge. (I’ll be honest that was usually me.)

My job role (pre lockdown) was primarily remote working, from home, coffee shops, libraries and other buildings with wifi, as well as travelling across the country to support our SMART partners. Sometimes I’m away for a few days at a time. A premier Inn deja vu experience with the same 2 veggie items on the menu and an overload of purple, interspersed only with visits to a treatment provider hub or a community centre. Of course now i am mostly confined to my kitchen table and online support and delivery like many of you, too close to the kettle.
I have done a CBA (cost /benefit analysis) on my job many times. I absolutely love what i do, and it certainly has some perks. It’s a relatively autonomous role and I get to travel the UK supporting recovery communities. The costs of that however are that it includes lots of lone working and staring at screens. I miss my family and friends at times when im away from home and it can affect my mood if i get complacent and don’t maintain my positive routines.

If you have heard about the rat park experiments of Dr Alexander, you will know that having a positive environment and connecting with others is essential in us maintaining long term recovery from our addictive behaviours. Now more than ever as we have been made to take a break from our usual routines and stay home, cutting out vital human connection we need to find new ways of managing our recovery and connecting. https://brucekalexander.com/articles-speeches/rat-park/148-addiction-the-view-from-rat-park

So how do we manage our thoughts and behaviours and keep good boundaries working from home? My working week typically involves unhealthy amounts of caffeine so I am in no way asserting i’m an expert here, but I’d like to share my experience and personal rules that have helped me, as someone in long term recovery.

Lifestyle balance is one area we need to be very conscious of. Are you taking breaks, are you working late frequently? A lifestyle balance pie can give us a good insight into areas we need to pay more attention to. I recently updated mine and found that i need to put more focus on fun activities or hobbies. Complete your own worksheet here – https://www.smartrecovery.org/smart-recovery-toolbox/lifestyle-balance-pie/

Check in with yourself regularly – It is very easy to slip into an unhealthy thought pattern and for us to allow it to affect our mood unconsciously. Observing our thoughts is a key part of the SMART Recovery programme, and where necessary disputing them. (DIBS – Disputing irrational beliefs). https://www.smartrecovery.org/how-to-dispute-difficult-thoughts/

Sometimes we work late and other times we get behind, we are all fallible, however this can increase our levels of anxiety as the typical structural norms of office closing do not apply to home working. There is no boss telling you not to work too late, or to stop scrolling social media, or to stop you having that extra coffee break. Of course, we don’t need a boss to tell us what to do. Right?  Absolutely nobody wants to be micromanaged, but it’s my experience that we do need to maintain some clear boundaries in order for us to be as effective in our roles, but also more importantly maintaining our wellbeing and recovery.

Here are a few things I do that help me:

1 – Triggers : Whatever your substance of choice or behaviour, always be mindful of your potential triggers and make a plan for managing them before they happen. Like a fire escape plan, it may not happen but if it does you know where to go and what to do.
(I do not have alcohol in the house, but also on reflection maybe I should get rid of my cafetiere) Remember HALT the BADS. Are you hungry, angry, lonely or tired? https://smartrecovery.ie/smart-recovery-tools/

We use the hula hoop metaphor for boundaries and being rational about what we can control. In the hoop = I can control. Outside =I cannot control +acceptance

2 – Work Boundaries : Keep to your contracted hours…!!!
When you live and work in the same space, time can feel somewhat immaterial and boundaries can become blurred. Be mindful of sending those emails in the evening, or working all day through your lunch and breaks. Ignoring boundaries is a surefire path to burnout. That presentation can wait until tomorrow. Ask yourself ‘is what i am doing part of my established job role?’ Personal boundaries : If you live with someone, be clear that working from home means ‘working’. Consider any other possible distractions. Procrastination can creep in for me and before i know it im hoovering my living room. Some level of flexibility is of course needed but be aware of your behaviours. What are your personal values? Are your behaviours aligned with those?

In SMART we use the 3 questions exercise. (i) What do i want? (ii) What am i doing to achieve that? (iii) How do i feel about what i’m doing? By bringing focus to the link between our feelings and behaviours it can help keep us motivated. Also ask; What could I be doing differently? How would that make me feel?

3 – Have a plan : Some days I will definitely wing it. Some days require more patience and acceptance. Either way clear structure is really helpful to keep you focussed. Block out your calendar with space for particular projects. Each morning I write down a list of 3 key tasks to be completed, including how i’m going to achieve that and who i need to speak to. This is a bit like a change plan worksheet and lists key tasks to keep me focussed. Of course general duties can sometimes dictate how the day goes and you may have to readjust accordingly. As with any SMART goals achieving them can help keep you motivated so keep them achievable.

4- Establishing positive habits : Without meaning to oversimplify it, maintaining long term recovery is largely about replacing bad habits with good. One of the most helpful bits of advice ive ever received in my recovery is to establish a positive morning routine. ‘Carpe dium’ (seize the day). Our whole day is filtered through that early experience. Rather than muttering about not wanting to get up, snoozing the alarm and chain smoking or drinking coffee as soon as i wake which invariably sets me off on a negative arc for the day, i have made a more concerted effort to focus on the small details of my morning and through repetition it has become normal, (well mostly, i am also fallible and can get complacent)

(i) Start early and create positive triggers. A short cold shower helps get my blood flowing. A morning meditation (even for 10 minutes) helps me calm the chatter in my mind and prepares me for whatever the day is likely to bring. Practice, persistence and patience are key. There are some great apps out there to help you get started such as headspace or calm.
(ii) I don’t look at social media or the news until after I’m at my workstation. Our phones are probably the first thing we pick up when we wake. (iii) Water before caffeine

4- Create your own PIE : (Psychologically informed environment). Make the place you work comfortable practically for those long hours slouched over a computer, but also taking into account your emotional wellbeing. Make sure you get plenty of sunlight. Put some quiet music on if that works for you. Get a plant. Put some positive affirmations up. Make it a place you do not resent being, and try limit potential distractions.

6 – Practice The 5 ways to wellbeing.
Being active (go for a short walk every day. It’s important to keep moving) changing environment can change your emotional state, and we need the sunshine.
Take notice ( inwardly of any physical sensations in your body inc breathing, your emotions. Outwardly notice nature, the sun, the animals at the bottom of your garden. Connect – Reach out to friends and family where possible. Attend online recovery meetings. Make a decision to do this daily. Keep learning – When completing your lifestyle balance pie do you have a slice of learning? Are you focusing on your personal growth? In whatever small way you can. Even if its learning a new hobby. There are many great online resources out there. Give Back – For me this is one of the most important parts of my recovery. from my time in early recovery as a peer mentor, to the charity work i do now. Giving your time in the service of others is an empowering experience.

Stay safe out there all you recovery warriors. social distancing does not mean social isolation. Reach out and connect but keep your boundaries. It may only be an online meeting, but without being dramatic about it that could be the difference between life and death. 💜💜💜

Carl Zuccaro – UK SMART Recovery National Coordinator England


Link to SMART Recovery tools and resources ;

https://smartrecovery.org.uk/online-meetings/

https://smartrecovery.org.uk/product-category/books/

https://smartrecovery.org.uk/about-our-training/

https://www.smartrecovery.org/smart-recovery-toolbox/

https://www.nhs.uk/conditions/stress-anxiety-depression/improve-mental-wellbeing/