On October 9, 2010, I had the privilege of sitting down with Dennis McCarty, PhD to discuss drug and alcohol addiction treatment in the US. I have the great fortune of working with Dennis, mostly by turning his printouts into PDFs and booking the conference room for him, and I’ve always been fascinated and heartened by the work he and his team does; I’ve secretly always thought of him as a bit of an unsung superhero – out there fighting the good fight. After reading some posts about drugs, addictions, and treatment here on TNB in recent months, I asked Dennis to share his thoughts on all of it from the angle of policy. Here’s what he had to say.

Those familiar with my Nervous Breakdown posts know that I’ve long crusaded for a secular alternative to AA. My complaints have been vociferous, my voice loud enough that I might have written each piece in ALL CAPS. Recently, however, I decided that it was time to act. I located a secular group with a philosophy in line with my own, one based on the work of Albert Ellis and his Rational Emotive Behavior Therapy. The group: SMART Recovery. The Facebook site, which I invite anyone interested to join: SMART Recovery Fan Page. If AA works for you, continued good luck. If not, I’m here to say you have a choice.

My mission is two-fold. Rather than debate AA — always a useless exercise — I have joined forces with SMART Recovery. Rather than bash the ubiquitous nature of AA, my first goal is to create a meeting here in Sarasota. My second goal, now underway, is to assist SMART Recovery (referred to as “SR” from this point forward) in a volunteer public relations’ capacity. But the latter is not my purpose here. Rather, I come to you as a citizen with a message. If your needs are not met by AA, alternatives exist, and SR is there for you.

First, visit the SR site. Stay a while; there’s plenty to do. You can read how the program works. You can participate in online meetings. If you wish, you can seek a meeting in your location. Such a meeting may not exist…yet. In that case, consider applying to become a facilitator. You can create an SR meeting yourself and do so fully prepared by SR. You will become a local hero for all those like you who searched for a secular meeting but couldn’t find one…now they will find one. Consider the pleasure to be had in knowing that you created an alternative that didn’t exist and which others like you can now access. Furthermore, by becoming a facilitator, you will in turn become steeped in the wisdom underlying SR.

You don’t often read the word “wisdom” in my posts, both because I lack it and because I rarely find it. But Albert Ellis was a wise man and, like most wise people, had two feet on the ground as he reached for new solutions to ancient problems. His approach is deceptively simple.

In short, it works like this: ABC. No, I don’t mean Always Be Selling.

Instead, I mean:

A: Activating event.

B: Belief.

C. Consequence.

Lastly:

D. Dispute.

Let’s apply this to drinking in a very simplified example. This is my description of REBT. For a much more in-depth understanding of the process, see the SR website and/or visit their Facebook Fan Page.

Back to my example. What is an “Activating Event”? In this example, it’s whatever makes you want to drink. For heavy drinkers, virtually everything becomes an “A.” This occurs because heavy drinking by itself produces irrational thinking. It kills rational thinking. No rational person decides to lose control over drinking. So why do they lose it? Drinking causes them to become more and more irrational.

I’ll use a typical “A”: “Today sucked. It kicked my ass.”

Now we move to “B.” What’s the drinker’s belief likely to be? Something like this: “I need a drink, and plenty of them.” Further, the drinker thinks, “Soon, it will all disappear. Here comes euphoria.”

And the “C”? The first consequence is easy to guess: hangover. That’s bad enough. But the consequences for heavy drinkers increase. Not only a hangover but the shakes commence, creating a brand new “A.” The drinker’s belief: “A few drinks will fix that.” In this case, the drinker is correct. Bizarrely, irrationality becomes the drinker’s new rationality. It’s rational to end the extreme anxiety that heavy drinking ultimately causes as part of withdrawal. However, irrationality has led the drinker to this point and without his knowing it. He may have rational moments when he considers quitting, but those moments quickly fade. Irrationality has become embedded in the drinker.

How to keep from getting to that point? And what should you do if you’ve already gotten to that point? In the latter case, you may need medical care. Seizures become a real possibility. Worse can happen. You may need to face detox. At the very least, you require supervision in case you do have a seizure. These medical issues lie well beyond my purview. Consult a loved one. Ask for their help. You need someone rational at your side and to help you find the best care available if you do require hospitalization.

If you’re not to that point, or you’ve gotten past that point, it’s time for “D.” The “D” is going to become your best friend. You can turn to “D” at any moment of crisis, anxiety, difficulty, irritation. “D” refers to disputing your irrational beliefs.

Going back to the example of a day that kicks your ass, the process of disputing your beliefs might go like this: “Sure, I’ll feel better for a while, but I’m going to feel like hell tomorrow and for much longer than I feel better tonight.” Run a cost/benefit analysis. How many hours does alcohol improve your life compared to the number of hours it ruins your life? If you’re a heavy drinker, or approaching the trouble zone, I guarantee you won’t be able to deny that the ratio does not weigh on the side of making you feel better. In fact, the day may well have kicked your ass because you drank the night before it.

A person can avoid the worst outcomes of heavy drinking by beginning this process now and working on it. Again, consult the SR website and/or their Facebook Fan Page for more information. I’m trying to get you to hope and the idea that there are alternatives to the “treatments” many of us simply cannot find our way into or around. For those who believe in reason and rationality as a means to overcoming problems, an alternative is required, unless, like some, you can find your way to a higher power through whatever means avail themselves to you. That’s your business. I’m not here to dispute your beliefs.

I’m also not here as an official representative of SR. I speak for myself and from my experience. REBT smashed my once-crippling anxiety and has reduced my melancholic as much or more than any anti-depressant. Is every day a pleasure? Hell, no. And I no longer expect every day to be a pleasure. In surrendering an insane demand, I surrender my insanity.

There is a secular alternative available to you. In fact, there’s more than one, but I happen to believe in SR’s approach because I know REBT is simple, effective and easy to put into practice. The rewards can be almost immediate.

When it comes to drinking, a lot more work will be required. Returning to the ABC YouTube link, will you do the work? Will you? Will you do the work? Or will you go to a three-cocktail lunch?