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Tuesday, 24 January 2017

मॉडर्न कोण ?


Image result for first drink with father

अलीकडेच अनेक नव्या रुग्णमित्रांशी चर्चा करताना मला अस वाटल की आपण सगळ्यांनी नव्यानी मॉडर्न म्हणजे काय याचा थोड़ थांबून नव्याने 
विचार करायला हवा. असा विचार येण्यामागिल एक घटना खलीलप्रमाणे:

 एका मध्यमवर्गीय कुटुंबातील सदस्य आपल्याच जवळच्या एका नातेवाईक कुटुंबास जेवायला बोलवतात। त्या कुंटुबात एक १५ वर्षाचा मुलगा आणि दोन १२ वर्षाच्या मुली आहेत . दोन्ही पुरुष जेवणापूर्वी ड्रिंक्स (दारू हा मागसलेला शब्द नको) पिण्याचा बेत आखतात। आपण आपल्या घरातील महिलांना सामान वागणूक देतो हे एकमेकांना दाखवण्यासाठी खास महिलांसाठी अशी 'रेड वाइन' मागवाली जाते। आता प्रश्न राहिला मुलांचा ? त्यांनी काय म्हणून पार्टीला मुकाव? मग त्यांना काहीतरी सॉफ्ट ड्रिंक मगावल गेल.
 वयात आलेला मुलगा मित्रासारखा वगवावा म्हणुन त्या बापान प्रमाणिकपणे मुलाला सांगितल की 'आज बुवा आमची पार्टी आहे'. मुलगा गालातल्या गालत हसला। बापला खुष पाहून पोरग आईकडे वळल. आई जीन्स आणि कुर्ता अशा वेशात मेकअप करता करता आरश्यात बुडून गेलेली। पोरानी आईला विचारल,'आई नवीन म्यूजिक ट्रैक आहे माझ्याकडे घेवू का ?' आई बोलली,            'हु हु पण पेनड्राईव विसरायच नाही बर?'

जय्यद आणि चोख तयारी निशी दोन्ही कुटुंबीय एकत्र येतात। दोघे मॉडर्न आई बाप सह कुटुंब ड्रिंक्स घेवू लागतात। पोर आपला दिवस कधी  येईल? या दिवास्वप्नात एकमेकांशी चर्चा करतात। त्यांना ऐकिवत असलेली दारुची जादू एकमेकांशी शेयर करू लागतात। इतक्यात १५ वर्षाच्या मुलाला त्याचा बाप म्हणतो,        'काय रे चव बघतो का? माझ्याबरोबरच बसून पी पाहिला पेग..... हअ हा हा ' 
मुलाच नशीब उजाडल (कोल्हापुरी भाषेत सांगायच तर नशीब फळफळल ) आणि आपले मॉम- डैड मॉडर्न असल्याचा त्याला आत्यंतिक आनंद झाला।  

विचार करायला लावणारे प्रश्न :
१. खरच का मॉडर्न होण आरोग्यदाई सवई पेक्षा अधिक महत्वाच आहे?
२.   आपण आपल्या मुलांना मद्यपान आणि सोसियल होण हे अविभाज्य आहे अस का बिंबवणार आहोत?
३. कुठल्यातरी आमुक वयात मद्यपान सुरु होण खरच अनिवार्य आहे का?

Tuesday, 17 May 2016

What is a role of therapy in addiction treatment ?





The most difficult part in addiction treatment is to make the patients open & ready for therapeutic activities.

when patients enter into the de-addiction & rehabilitation centre for long-term treatment most of them reported the hopelessness, self-pity, anger at self and others, blaming etc.
The only way to help the patients is to make them participate in various therapeutic activities.  Some of the famous therapeutic activities are as below.

1. Motivational counselling: As a therapist that at one point of time an addict also feels that he has to stop using the substance, but fear of withdrawals, lack of information about treatment, unable to ask help stops him from taking action. Motivational counselling can help people to make the decision about the treatment.  It brings hope for recovery. Motivational counselling puts the light on the present painful conditions of an addict and makes him aware that there is a way out.

2. Developing Insight: once the patient got motivated then the next challenge is adherence to treatment.  The craving, confusion, peer pressure rules the addict, Most of them quit the treatment after detoxification. focused individual assignments & counselling sessions often help people to get the insight about their severity of addiction & the impact of it.

3. Expressive therapy: An addict needs a supportive empathetic atmosphere to express his feeling. He needs assistance to express his opinions, experiences, perceptions. Expressive therapy provides an opportunity to express the deep-rooted feelings either in a direct way or in an indirect way. It consists psychodrama, poster making, games,  group discussion, art and music therapy.

4. Challenging the old beliefs & thoughts: This is the core part of therapy. The patient learns to challenge his old beliefs. Introspection of thoughts helps him to learn new coping skills to lead the productive life. changing the thoughts and beliefs improves the healthy decision-making.

5. Family & Marital Counselling: After the discharge, the family becomes a supportive network. If family counselling aims to deal with old perceptions, hurts & negative thoughts, helps family members to be a part of support system. Addict also needs to realise how the family is suffering because of his addiction. at the end, the role of family members in recovery, learning about the disease of addiction, communication styles in the family also needs to be addressed.

Sheetal

Monday, 30 November 2015

Self deception part 1: Denial


When it comes to addiction treatment; therapists, clients, and families they defiantly discuss denial as an important aspect. There is a lot of literature available on Denial.

Here we will try and understand denial as a self-deception tenancy. My post on deadly D's has an explanation on self-deception. In short, self-deception is something which prohibits the recognition and acceptance of the disease and the negative consequences. Denial is the first part of self-deception which always help the addict to be in illusion that nothing to worry..... I can stop using anytime....... or I can control my using...... I know there is nothing wrong if I drink or use....etc.

Eventually, addicts come across the negative consequences but their denial never allows them to see the reality. E.g. few addicts justify drinking saying that limited amount of drinking is good for the heart, good for xyz....etc but they fail to understand that when liver report clearly indicates the dysfunction due to the excessive, harmful use of a substance. They still stick to the selective information which supports the using. 

DENIAL IS REFUSING TO ACKNOWLEDGE THE HARMFUL CONSEQUENCES OF ALCOHOL OR DRUG USE.

What I observed during my practice so far is we can make few categories according to the responses of various addicts which shows the patterns of denial.
1. Denial by defining the problem
2. Denial by blaming or by creating problems with external factors.
3. Denial by minimization.

Let me explain all three points elaborately.

1. DENIAL by defining the problem: addicts feel that if they can give strong reason to use no one will blame them. The other type is kept on proving people that they are functional and able to achieve something.
Like this kind of people, they say that 'look! I have a good job I am earning then how can I be an alcoholic or addict?'
My doctor only prescribed me those pills.... so I am using them.... how can I be an addict then.
But the reality is they fail to see the whole picture. They overlook the other evidence such as the withdrawals, preoccupation, cravings, family conflicts due to use, accidents under influence, fail to cut down or stop using.

2. DENIAL by Blaming or by creating problems with external factors: Most of the addicts throw the blame on external factors. they mention rather justifies that how other people and their behavior is only causing the problem. This kind of addicts may mention job pressures as the reason for alcohol/drug use. they may mention that they drink because of critical wife, physical pain, someone is trying to corner etc. 

They look at the substance as a remedial part but they fail to understand that abusing alcohol or substance is putting them again into a problem rather aggravating the problem instead of solving them. Eventually, they create new problems for them. E.g; if one keep on blaming that wife is a reason for drinking; in turn, he makes his relationship more stressful with a wife. He never puts any efforts to talk about how is he getting affected by his wife's behavior or never makes an effort to openly talk to her. after some period he faces separation. then he again starts drinking more saying that his wife left him. 

3. DENIAL by minimizing: To avoid the confrontation many times addicts stops defending themselves but in such situations, they opt for minimizing the amount they use and also minimizing the harmful consequences they face so far. 

this kind of people they say ...... yes! I drink.... BUTTTT no as much as you think... Just 2 pegs... 
No...believe me! my accidents were not under influence. I do drink but its not as bad as XYZ. 


Eventually, addicts get confronted with harmful consequences. that point they are unable to deny the use &/or negative consequences of addiction. However, the story doesn't end here. 


Unknowingly, once denial stops working they go to the next level of self-deception. 
To know more read my next article.... 

SHEETAL BIDKAR











Saturday, 22 November 2014

Slogans of Strength


I feel that people need to search some or the other tool for self-motivation during the recovery. In early abstinence people face a lot of challenges, the risk of losing the zeal of hopeful life is high in this period. I found old timers in AA always use the slogans. here I am sharing the few which I use to motivate my clients who want to walk the path of recovery. I must honestly confess at these slogans have given me a positive energy during the difficult times of my life. 

Note: All the slogans are from the AA literature. I use till and found them very useful so I am sharing them with all of you.

  1. easy does it
  2. first things first
  3. live and let live
  4. think......think.......think
  5. one day at a time
  6. let go and let God
  7.  kiss---keep it simple stupid
  8. this too shall pass
  9. "Be nice to sponsees they might be your sponsor some day"
  10. expect miracles
  11.  stick with the winners
  12. sobriety is a journey ..........not a destination
  13.  poor me.....poor me............pour me another drink
  14.  live in the NOW
  15.  turn it over
  16. aa=altered attitudes
  17. be part of the solution, not the problem
  18.  no pain.........no gain
  19. go for it
  20. do it sober
  21.  let it begin with me
  22.  just for today
  23. pass it on
  24. don't quit 5 minutes before the miracle happens
  25.  practice an attitude of gratitude
  26.  god is never late
  27.   90 meetings in 90 days.........90/90
  28. you are not alone
  29. use the 24-hour plan
  30. stay sober for yourself
  31. First drink does the damage
  32. when all else fails, follow directions
  33. change is a process, not an event
  34.  call your sponsor before, not after, you take the first drink
  35.  sick and tired of being sick and tired
  36.  it's the first drink that gets you drunk
  37. what if........
  38.  help is only a phone call away
  39. around AA or in AA?
  40.   K.C.B. --- keep coming back
  41. courage to change
  42. easy does it, but do it
  43. if I think, I won't drink. if I drink, I can't think
  44. get it ---give it---grow in it
  45.   principles before personalities
  46. to be forgiven we must forgive 

Sheetal 



Thursday, 30 October 2014

काय झाले?

काय झाले?

मागच्या एका वर्षभरात १७ ते २५ वयोगटातले अनेक व्यसनी रुग्णांशी संपर्क आला. त्यासर्वांमधे एक समाइक असा बेफिकीरपणा दिसला, त्यांनी त्याचे आयुष्यातील गंभीर अडचणी किती क्षुद्र असल्यासारख्या मांडल्या आहेत; यावरूनच त्यांचा जीवनकडे पाहण्याचा दृष्टिकोन दिसून येतो। हे सगळे खरच मनाला सुन्न करणार आहे.


मी जरा फिरलो कॉलेजच्या बाहेर
तर कल्ला करायला काय  झाले ?
मी जरा गेलो पार्टीला तिकडे
तर बिघडला म्हणायला काय झाले ?


अरे बाबा! सगळेच जातात गोव्याला प्यायला
तुम्हाला लगेच चिडायला के झाले ?
राहिला बैक लॉक इंजीनियरिंगला
तर वाया गेलो म्हणायला काय  झाले?


जरा कुठे मनेवर टट्टो काढला
तर गंजेड़ी म्हणायला काय झाले?
बसलो जरा मैत्रिणीच्या कड़े  डिनरला
तर  बायको म्हणायला काय  झाले?

बुडले पाच-एक हजार पैज लावून
तर कर्जबाजारी म्हणायला काय झाले?
मागितले मित्राला लाखभर रुपये
तर कर्ज केले म्हणायला के झाल?

हो हो येतोच कंटाळा घरी राहायचा
दोन दिवस न सांगता गेलो फिरायला
तर शेफारला म्हणायला काय झाल?

अहो होतोय ना त्रास माझ्यामुळे
मग सोडून द्या मला एकट
नाक कापल म्हणून हिनवायला  काय  झाल?

जमत नाही ना माझ तुमच्याशी???(अगदी उद्धट स्वरात )
मग करू वाटा वेगवेगळ्या
तुझ्या काळजीन जीव चालला म्हणायला काय झाल?

आयुष्य खुप सोप्प आहे
फायद्याच्या गणितच फळ आहे.
मर्जीच राजकारण खेळातच जवानी जगण आहे
नाहीतर.... नको नकोस ओझ आहे
नाहीतर.... नको नकोस ओझ आहे

Tuesday, 30 September 2014

वेदना




विवाह समुपदेशन हा व्यसनमुक्ती उपचाराचा एक अत्यंत महत्वाचा भाग आहे. अशाच एक सत्रात एका रुग्णमित्राच्या भावना कशा बदलत गेल्या त्याची ही कथा. आधी तो आला आणि तिचा अंदाज घेण्याचा प्रयत्न केला, मग थोड़ा राग आणि तिरस्कार दाखवला आणि सरतेशेवटी तो पुरता अंतर्मुख झाला।






वेदना


ती डोळ्यात आशांची आसवे घेवून बसली होती 
न रहवून माझ्या चांगुल पणाची कड घेतच होती 
भला होतो म्हणे मी लग्नाच्या वेळी 
मोडित काढला संसार म्हणे मी तिचा याच दारूपाई। …… 

खरच। ……… का हे खर आहे?
आजार मला आणि वेदना तिला आहे 

मला वाटायच। …  मीच ना पितो?
मग त्रास तिला का बर होतो ?


आज ती खर बोलली 
तिची वेदना डोळ्यातून वाहीली 
कितीदातरी मी  तिला मारल
संसार वाचवायचा म्हणुन 
हरबार तिन कटु बाजूला सारल 

मला कळलच नाही तिन कित्येकदा असच सावरल 
माझ्या चुकांचे चटके सहन करून 
माझी काळजी कारण कस तिन पेलल?
माझी काळजी कारण कस तिन पेलल?


शीतल बिड़कर 

Monday, 29 September 2014

Breaking the behavioural CYCLE


We are responsible for our behavior. It is true that social, psychological & environmental pressures may influenced ones drinking/using behavior. In order to make a change one need to categorized these pressures.
i. Pressures come form others
ii. Pressures come from within ourselves.
iii. Pressures come from environment

People in addiction complains that they want to change but other people & environmental things pulled them back to substance abuse. As I mentioned earlier we will discuss the above mention pressures  one by one.

I. Pressures come from others: in many communities takings alcohol in social gatherings is very common.  This gathering is an external factor which can pull the individual in a risky situation. Social acceptance may influence how much we drink, what we drink, it may also effect the place and time one may opt for drinking. Social pressures also influence the attitude and perception towards alcohol use.

I I. Pressures comes from within ourselves: alcohol, drugs alter our mood one may use it as a coping mechanism. The unhealthy coping mechanism eventually doesn't work and people get confronted with the real harsh consequences of their choices.  Fears, insecurities, resentments and other negative feelings aggregate the intensity of the discomfort and people feels that substance may help them to handle these discomforts.  Our pattern of conditioning our behavior and beliefs definitely influences the acceptance of substances.

III. Pressures come from the environment: availability of substance, peer influence, weather conditions are examples of environmental factors which may influence the decision of substance use.


In order to break the behaviour cycle one needed to use new behaviours for dealing with social and psychological pressures.  Some suggestions are as below.

1. An aviod situation which you feel you may not be able to handle.
2. Plan your reactions to handling peer pressure.
3. Learning new coping mechanisms.
4. If the stress or tension is chronic then seek professional advice.
5. Know your triggers and plan for healthy precautions.
6. Find the positive, healthy alternative activities.
7. Socialisation with self help group members will be very useful.
8. Taking efforts to understand the exact nature of the disease will help us to set some do's and don'ts for ourselves.

Practicing new behaviours will lead to develop healthy behaviour cycle.


Sheetal