I worked at a private neuro-psychristric hospital with dual-diagnosis patients who not only sought help to recover from addiction, they had psychiatric disorders. During individual sessions I sat behind a big desk with a panic button on the bottom of the middle drawer. If a patient became violent or threatened violence, without pause or hesitation, I pushed the button.

A series of chimes sounded on the first two floors of the hospital disclosing the location and of the incident, but not the third floor where my office was located to avoid escalating the patient’s behavior. Staff trained in crisis intervention and management rushed up two flights of stairs (this was much faster than taking the elevator), bolted down the hallway, and burst into my office.

Thank God for big burly men.

Sometimes, we talked the patient down. Sometimes, chemical restraint was administered by nursing staff. And sometimes, patients were hauled off spread-eagle and face down  by four staff members who placed them in a secluded room commonly called a “rubber room” where hopefully they could not harm themselves or anyone else.
I have stood in the room with a patient that was Viet Nam veteran who believed we were in Saigon.

“I ought to rip your fucking, slanted, black eyes right out of their sockets.”

Spittle spewed in my face as he spoke.

It’s worth noting I have green eyes, and am a non-Asian who is Native American, Irish and German.

I was the supervisor at a free-standing social-model detox center where we (the staff on duty) were left with only our own resources to deal with combative clients. We had no back-up security staff. No emergency room. No psych unit. No standing doctor’s orders for a calm-your-ass-down shot. If we needed help, we called 911. We did the best we could with what we had to work with until they arrived.

A distraught mother brought her 14-year-old daughter in for an assessment who was high on PCP and believed she was locked in a closet. She weighed 95-pounds and knocked me half-way down a hallway with one punch when I asked her to stop clawing  her face. At that time, I weighed around 140 pounds. It took four guys to hold her down until the paramedics arrived, strapped her to a gurney, and transported her to a hospital where she received the medical intervention necessary to stabilize her before we could provide treatment services.

Then there was the time when “Jesus” and “satan” were both patients at the same time on a locked psych unit where I worked.

These same patients, once stabilized, attended Alcoholics and Narcotics meetings.

Initially, they went our in-house Hospital and Institutions meetings. In the later stages of their treatment, we transported them to Twelve Step meetings in the local community.

It was not uncommon for someone who was my client or patient during the day to sit across the table from me at an evening meeting, or attend the same AA and NA dances, or anniversary dinners.

In the Twelve Step arena, we were both just alcoholics and addicts.

Ethically, I can not establish personal relationships with patients or clients. I can not sponsor them, give them my address or phone number, go with them for coffee after meetings, give them money, accept presents from them, give them a ride, date them, have sex with them, or even take them to church. Prohibitive professional boundaries protect them, and protect me.

Chronic late-stage alcoholics with Post Traumatic Stress Disorder and a history of flashbacks, adolescents who love PCP the way fat girls love cake, and paranoid schizophrenics with psychotic episodes who refuse to take their medication, once stabilized and compliant, can blend in at Twelve Step meetings and functions.

Before I got clean and sober, if you drank, drugged, and shared– I was your girl. I wanted to be your best friend. Sometimes, I wanted to be your only friend so there’d be more for me. And when your money, liquor, and dope was gone, so was I.

“If you are smart, you are gonna use me the way I’m gonna use you.”

~ Anonymous

I developed a high-tolerance for people who acted like I did: crazy, chaotic, irresponsible, unpredictable, inconsistent, and unhealthy.

In recovery, I hook-up with people in the program at meetings, AA clubs, and coffee shops and invest the time to get to know who I am associating with before I invite them to my home, and into my life. I put forth the effort to keep crazy out of my front room, and keep my home a safe place for my daughter and me.

One of the recovery slogan says: “Stick with the winners.”

I had to figure out how to identify a winner before I could stick with them.

• Winners don’t thrive on chaos and adrenaline.
• Winners don’t have ulterior motives.
• Winners don’t take emotional hostages.
• Winners don’t manipulate with guilt to get what they want.
• Winners aren’t players.
• Winners don’t forget where they came from.
• Winners don’t collect followers. They don’t sponsor 453 people by name, yet help no one because they are too busy to even take care of themselves.
• Winners know how to keep their mouths shut. They won’t put your business in the street.
• Winners have the courage to say, “No.”
• Winners walk the talk.
• Winners work the Twelve Steps.
• When winners say they are clean and sober, they really are.

Recovery Rocks!

Roxie

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