Casey Arrillaga: How has addiction affected your family?
Female Speaker: It robbed me of my father.
Female Speaker: Addiction's affected my family in absolutely every way.
Male Speaker: It has caused a lot of turmoil.
Female Speaker: It goes back to what I understand is at least three generations.
Female Speaker: It robbed my daughter of her mother. It robbed my mother of her daughter.
Female Speaker: Addiction has made our family quite challenging.
Male Speaker: Addiction has affected my family tremendously.
Male Speaker: It's affected my relationship with my sister where I wouldn't – I'd go for months without talking to her. It's a very difficult thing for everybody involved. It doesn't just affect the one individual. It's a disease that affects the whole family.
Male Speaker: Addiction is spread not only genetically through some of my relatives and I assume ancestors.
Female Speaker: It's generational.
Female Speaker: I think of him every day.
Casey Arrillaga: Welcome to Addiction and the Family, a podcast by and for family members of anyone with an addiction. My name is Casey Arrillaga, and I'm a social worker and addiction counselor at both Windmill Wellness Ranch and InMindOut Emotional Wellness Centers in Texas.
Kira Arrillaga: I’m Kira Arrillaga, addiction counselor intern and recovery coach at Windmill. Casey and I were in our addictions together for over ten years and now have been in recovery together for almost twice that long.
Casey Arrillaga: I’ve lead hundreds of family workshops, but just as important is that Kira and I have lived the experience of being family to addiction as both children and adults.
Kira Arrillaga: Join us as we offer experience, strength, and realistic hope about how you and your family can find recovery together. In this episode we’ll hear Casey’s interview with Dr. Al Mooney, who has an amazing story of both his personal recovery and his professional contributions that have helped so many people around the world who struggle with addiction in themselves or in a loved one. His story spans 60 years from the age of 10 until today. He talks about how his father found recovery, what it was like to grow up in a family centered on recovery, and how he incorporated this background as he left home to find his own way in the world and how his career in addiction medicine has taken him to many different places as one of the pioneers in the field of addiction medicine. We’ll hear this interview after a word from one of our sponsors.
Kira Arrillaga: Welcome back. Let’s hear that interview.
Casey Arrillaga: Hi. Welcome to the program. Why don’t you go ahead and introduce yourself and let us know what are you doing at a podcast called Addiction and the Family?
Dr. Al Mooney: Hello. It’s good to be here. My name is Al Mooney, and I’ve had a lifelong journey with addiction and mostly recovery. I’m a physician and have done addiction medicine. Probably the most important part of my journey is having grown up in an alcoholic addict family. I’m old now, but I got into recovery with my family a long, long time ago just after my dad got sober in 1959. It’s good to be here, and I look forward to sharing more of my journey and hopefully connecting with some people who are searching for solutions or knowledge in their life related to recovery from family addiction.
Casey Arrillaga: Well, I really appreciate that. I’m glad that you’re here. Would you mind talking a little bit about what your family was like before recovery and then how they found recovery?
Dr. Al Mooney: Sure, Casey. I enjoy what you’re doing in our interview. It’s a little different than a lot of the work that I do because I’ve been taught to segment my life. Either I’m dealing with something on a personal side or I’m wearing my professional hat. I’m intrigued and in some ways motivated by the way your interview seems to be taking on even as we begin about my journey. There’s a lot of personal side, but there’s also a professional side. I hope we can get into both of these areas.
One reason it’s important to me is because in our society and in most societies around the world, there’s so much shame, guilt, and stigma related to addiction that we have trouble connecting with the healing. I am fortunate to have not had that kind of start to the recovery in my family. I’ll tell you a little bit more about that. That journey for me has continued to be a pursuit of what I call my intellectual curiosity. We think of most of the healing being emotional growth and things that are not real brainy.
As a matter of fact, the brainy stuff gets in the way of recovery a lot of times. However, I’ve been around a long time. That brainy stuff, even though I know it doesn’t heal me, it adds validity to my plight in addiction. It also gives me some power to understand and move forward with the healing that needs to happen.
Casey Arrillaga: I agree so much with what you’re saying there about that pursuit of knowledge. It’s something I really encourage in my clients who struggle with addiction, but also especially for the family members. What I’ve found is that when people understand what’s going on around addiction and recovery, what’s happening in brains and their bodies, I include family members in this. I think family members go through a lot addictive or compulsive or obsessive behavior around their loved one trying to get their loved one better.
Even if that isn’t happening, the family members often are going to physiological and neurological stress just watching their loved one struggle. I think all too often people are not stopping to say does the family member need to recover from that? If people get the education and they understand what’s actually happening scientifically, it can help remove stigma both for the person with the addiction and for the family members to be able to let some of that go and get some relief.
Dr. Al Mooney: That’s certainly a concept that connects me. I’m lucky because at such a young age I was exposed and not just exposed, but immersed in recovery. My dad, I call him a World War II war hero, and he was. He was a paratrooper in the 82nd Airborne. He flew in gliders, but his glider crashed.
He had a back injury, but out of that back injury from that World War II glider crash, he got involved with narcotics. It was alcohol-involved narcotics. He came back to practice medicine. He ended up getting sucked into the addiction and ended up in prison from an addiction problem. That’s where he found recovery.
In the 82nd, for those people that are familiar, it has a shoulder patch AA. It stands for All American. When I started hearing the letters AA mentioned, I wondered what in the hell are a bunch of paratroopers going to do to change my family life so much? It took me awhile as a kid to figure out exactly how all the alphabet worked together to help our family. I didn’t know what was going on, but it was interesting how the recovery that I was so unaware of really lifted a burden of confusion and guilt off my shoulders.
Dad and Mom both would go away. They both had to be in institutions before they got sober. My dad was a doctor, a prominent surgeon in the area. I’d say, “Where’s Daddy gone?” Nobody, I guess, wanted to lie, so they said he’s off learning to be a better doctor. Sure enough, when he got out of the mental institutions, when he got out of prison, he was a lot better.
Nobody was honest about what was going on until he came back home with – it was early recovery, but he was in good recovery. When I asked the question directly to him, “Where have you been?” he was honest. He said, “I’ve been in prison.” It was strange because you think when your dad tells you he’s been in prison, that that would have been even more burden. The burden was immediately lifted off my shoulders because I knew he was a smart guy and could have made up any kind of story he wanted to, but he didn’t.
I knew for the first time in my life that was the truth. We say around recovery the truth will set you free. The one thing that I heard, I saw in him, he planted a seed of curiosity with me that I have continued to have up until this day. It was the same body that came back that I knew as my dad. There was a different person in it.
It was as though at 11 years old when he got out of prison that I met my dad for the first time. It was like a Twilight Zone minute. How did they put a new person in that old body that I knew so well? In the program of recovery, AA calls that the psychic change. People in recovery see it all the time and almost take it for granted.
Just in the last few years science has begun to understand what we call neuroplasticity and the concept of positive neuroplasticity. Sometimes in recovery we have to be patient for the scholars to really explain what we know to be our reality. That’s been a big part of my journey in the family is going from that ten-year-old boy very confused because nothing made sense.
Now an old man, as I’ve continued to participate in this journey, light bulbs are going off every day. I’m surprised it’s still so engaging after all these years, but it seems to be. To me a lot of that is the journey of a family recovery that is not just limited to me. I found that so many other people in recovery are just excited about the mystery behind what comes up around every corner.
Casey Arrillaga: Thank you so much for sharing that. Something I want to highlight for our listeners is where you talk about being honest with the kids. This is a concern that I hear from a lot of family members is how do we shield the kids? Should we be honest?
In your story your dad is just straightforward, and he talks about exactly what happened, but frames it in ways that a child can understand. I’d like to think that that is always possible, that we can be honest. That is healthier for the family. It’s healthier for the children. It promotes recovery, and it doesn’t involve having to keep secrets anymore. That’s such a hallmark in addicted families.
Dr. Al Mooney: One of the cool things is that I’ll have these life experiences because I didn’t really have a choice. Our family was immersed in recovery in order to live. My folks got involved and stay involved in recovery, and we did it as a family. The vacations we took, camping trips, we went to conventions, all of them related to the recovery fellowships. Then when I got into medical school, so many things in my medical training were either dramatically right or dramatically wrong, and the light bulbs continued to go off.
Curiosity to learn more really captured me. I stuck with this a long, long time and don’t intend to quit. One of the things, you talk about that childhood experience of getting the truth, I’m not saying you need to tell your whole story point by point, do a fifth step with your kids, but the honesty, age, and developmental appropriate is probably a good thing. It really worked well for me. I was told what went on. Instead of feeling bad that my dad was in prison, somehow it released me from a pain and suffering that I didn’t even know I had.
Often when these things are done in recovery, even if we don’t have the firm science, it turns out to be the right thing. Particularly with Alcoholics Anonymous recently, there’s good research now that’s just begun to come out this past year. It talks about how effective Alcoholics Anonymous is. It’s amazing that it’s taken so long to come out. It’s also amazing that millions and millions of people have benefited before the final authority of research determined that it’s a solid evidence-based practice. I’m so glad that that happened because this merger of intellect and science with recovery has been an important part of my journey. Not everybody is into the nerdy stuff like I am, but if I can use my talents and interests to strengthen my recovery, I’m really not sure why I wouldn’t want to do that.
Casey Arrillaga: Absolutely. I’m a big fan of educating families. It’s part of the reason that we do this podcast. I wonder, we talk about developmentally appropriate ways to discuss things with younger family members, but I find that older family members can also get shielded. Don’t tell Grandma that one of her grandkids is struggling. I think she probably knows something. She’s been around.
The family culture of secrecy, no matter how well-intentioned, can end up protecting the addiction instead. We are as sick as our secrets. I advocate for what I call the Mr. Rogers approach. If you look back at his show, he found a way to talk about grief, about insecurity, about death, about wanting to die. He could talk about all these heavy subjects as well as joy and laughter and wonder. He would talk about them to a really young audience. I wonder how would you recommend talking to younger family members or older family members about issues of addiction in the family?
Dr. Al Mooney: I don’t want to get too far off the subject that you want to talk about, but you mentioned older family members. It’s something that I’m rarely asked to talk about. People don’t usually even think about that. Even in good recovery fellowships, sometimes people get to the end of life and it’s like walking off a cliff. We kind of forget about them. We spend so much time thinking about the happy, joyous, and free life we live in. We often minimize, I guess is a better word than forget, the end of life phase. There’s very little research done on this if we get into some of the life’s work that I’ve done with the recovery book where I talk about red, yellow, green zones of recovery. I talk about the end of life that goes through a reversal of the mature growing phase that recovery has. I think there’s a Confucius quote that says, “Once an adult, twice a child.”
It’s that end of life is so important and not either researched or attended to like I would think it should be. I’ve been thinking this way for years. As I get older, I’ve got a lot more of this concept on my mind than I ever have. I think as we get older, we have ideas that are harder to shape because we’ve got life experience that has confirmed a lot of what we believe. If that life experience has been a script of suffering from addiction, those older years can be some of the hardest to endure because the tools of recovery have never penetrated some of our firmly-held beliefs that need to change for us to be better.
It’s never too old to go into a recovery program as a family member. With the pandemic, it’s even more interesting because now for those people that have disabilities and have trouble getting out for any reason, we could do all of that now right at home through technology with a virtual recovery world. I’ve got meetings that I go to all over the world, England, Africa. I was in a meeting yesterday where ten people from three continents and five or six different time zones all in one meeting. These are real heroes of mine in recovery that I never would have dreamed of having in the same room. There are things that we can be grateful for, even in hard times like we’re going through now.
Casey Arrillaga: Absolutely. I really feel the idea that both younger and older family members who can’t just jump in a car and run off to a meeting can now take advantage of all those online meetings and phone meetings. There’s a lot of different resources out there. You referenced earlier that within your own family you all went to conventions together, traveled together to other recovery events. I wonder, did they just have you go to the same recovery fellowships they went to or did they encourage you to find your own recovery? If so, about what age did that happen?
Dr. Al Mooney: From the time my folks got sober and everybody came home from whatever institution they happened to be in, we were living together around recovery. It was very different back in those early days. My dad got sober in 1959. He came home in November of 1959. Most of my family recovery journey began in 1960.
During that first couple of years, there was a community fellowship that I was immersed in. For example, today when people go to meetings, people go to the meeting. Then when the meeting is over, they go home. Often the family is not even in the equation. Back in those days there were two meetings a week in the little town we lived in.
Mom and Dad would eat supper, head out to those meetings. Sometimes there was a Saturday meeting where there was what they call a birthday party when somebody picked up their token or chip. They would often have a meal. We would actually go eat dinner at the meeting and then hang around for the meeting. Often the talks were entertaining.
A lot of times people in the community I knew, so there were some familiarity with the lives and the problems and the kids that these other people had. We had a lot of kids that would hang out. On those other nights, they would either go in a car or a carpool. They can take seven, eight, nine people in the Volkswagen bus and they’d head off an hour or two down the road to a meeting.
On the way they would stop by someone’s house. Often it was our house and just be hanging around for 45 minutes waiting for everybody to get off work, getting ready to go to the meeting. Then after the meeting when it was local or on the road, there would usually be a house that people would go to and just kind of debrief the meeting. They would just talk. That was done openly in our home.
That’s where a lot of my interests began. We had a living room right next to a long string of stairs up to the second floor where my brothers and I had our bedroom. I remember lying at the top of those stairs listening to the discussion and being fascinated by it. Often they would play tapes because even in those days, there were AA speakers at conventions. These speakers would be the people that would hit the road sometimes and go from convention to convention because they were so eloquent in the way they described their recovery.
I would listen to the tapes. The experiences were just entertaining and enlightening. It was such a positive experience to me as a child because it wasn’t like I’d come out of such a traumatized childhood like I know a lot of people do. It wasn’t like when we got into recovery that I was shielded from it. I was just brought into recovery. It became really a part of my family life.
I look for examples even now. There are some good ones where families can do these things together in fellowship instead of the person who identifies with recovery being torn away from their family to go to their meeting. At least in those days, it was comforting to me and healthy for me to be part of a family recovery that I may not have chosen to go to alone. Participating in the family made it really meaningful and much easier.
Casey Arrillaga: That’s a great testimony. Just so you know, at meetings I’ve attended in various recovery fellowships, I’ve seen a lot of people bring their kids. That still happens to this day. I wonder, was there a point where it started to feel like your recovery?
Dr. Al Mooney: There’s fellowship for teenagers. I had to wait until I got 13. When I started going to a meeting for my own recovery, it was a time as a young teenager I was trying to act like an adult anyways. All the adults I knew were healthy and sober and having a good time across the street at their meeting. We had the kids. We were all teenagers.
We started our own meeting. It was a natural continuity from just being a child tagging along to a teenager who now had ownership and our own meeting. It became an important part of my life. It was not as mature as I think about meetings today. There’s a lot of study of the literature. They AA Big Book is really dug into. Every word and phrase is torn apart for the benefit of building a good recovery.
As a kid, there were just a few pieces of literature. There were a lot of personal experience and fellowship. The way I remember the early 60s until I went off to college in 1966, the program was primarily built around group interaction and fellowship and all these families. Yes, we talked about meetings and literature and steps, but fellowship was a huge part. I think that goes back to when recovery started in 1935.
There were hopeless people who were highly educated, for the most part, at one point in their life very responsible people. Individually there was no hope. They had done everything they could and failed. Somehow the bond of fellowship created, as an English teacher would say, a first person singular world of I to a first person plural world of we.
That minor adjustment and perspective of life created the fellowship that the hopelessness of addiction was able to rise out of. People that read the steps carefully, it never mentions I or me. It’s all about we and our, first person plural. That’s kind of the magic. I live that magic in my teenage years.
Casey Arrillaga: You talk about people who are highly educated and you yourself of the long family tradition of going to medical school. Can you talk about your journey from being a child and adolescent in a family of recovery into becoming somebody moving into the educated and professional world as someone in recovery?
Dr. Al Mooney: Yeah. I feel like those stars lined up for me going from a personal recovery that I was immersed in with family – it wasn’t just me personally. It was a whole family recovery, which was very important. I see people who get involved in the intellectual early before there’s a foundation of personal recovery. It doesn’t often end well. It was a little different for me because we were immersed in the recovery.
Then after about eight years of recovery when I headed out to college, I was back on weekends and there was still a lot of family recovery going on there. It was a shift, and I got to a lot less of the recovery activities when I was in college. At medical school, my life stopped. It was all in the library or in the labs and those kinds of things. There was an interruption during those years.
During the time I was in college, attitude of recovery, I found that some interesting things had happened. This was in the 60s and the hippie days and LSD and marijuana were coming on the scene. There was something about my life experience. Much as I had classmates and good friends, I hung out in the fraternity with people who did a lot of drinking and drugs. Somehow that experience imprinted me because of the honest interaction we had in our family.
I became the designated driver before there was a designated driver invented. I loved the social structure of the people that drank, but there was something about me that didn’t jump into the alcohol and drug use. I can probably count on one hand the times that I drank. Part of that was I’m in a marriage – I met my wife in college. We’ve been married about 48 years.
We had a bond in our relationship where that wasn’t important to her. I had a buddy in college not drinking and doing drugs. I had to reflect on that later, realize how important that was. I did see things that I was prepared to question. There’s a social kind of attitude. Isn’t drinking great?
People often put the alcohol and drugs up on some kind of pedestal. I always thought it was strange. I had people come up into the fraternity house throwing up in the toilet the next morning after a party. They asked me what kind of time we had. They said, “I bet we had a good time last night, didn’t we, Al?” I’m looking at them throwing up in a toilet. I’m saying, “What’s wrong with this picture?”
It was as though there was a mentality that revolved around the alcohol and drugs that made no sense. Without the family recovery and the exposure I had to the good things that happened in our family, I don’t know that that scene in a fraternity house would have had the impact it had on me. It strengthened my desire to look for alternatives to alcohol and drugs in my life. I took up flying. I’m a pilot flight instructor, aviation medical examiner.
Flying has been a big part of my life. When you go out and fly, you don’t have a hangover the next morning. You enjoy life much better than a chemical can do. It’s not like I gave up anything to be abstinent. It’s like abstinence gave me a platform to achieve many more things in life than a lot of people don’t even know were there for the taking. That was a lot of my experience in high school.
In medical school it was different. There was almost no medical education in addiction to doctors. My training was no different. I had a couple of doctors that pointed out addiction to me. I had one senior resident that said, “It’s really important to identify all your alcoholics because there’s nothing you can do for them. You need to turn your attention to all the other patients.”
I’m thinking is he nuts? Every alcoholic I’d ever seen seemed to get sober and live happily ever after. I think in other days we saw more recovery success than we do today. That’s more of a professional question to get into. I think it’s true.
There’s another concept that hit me back in those days because this was my dad returning from prison. He was in prison because he was diagnosed at some point in there as a sociopath, which means you’re born to be a criminal. When he got out of prison and got sober as a physician and my mom was a nurse, they started taking people in our home. They didn’t understand that recovery was seeing people at meetings and being a sponsor and all that. The whole addiction field was not very well defined.
This was the embryonic stages of addiction recovery professional treatment. Eventually, my parents almost went bankrupt trying to help other alcoholics get sober thinking that they needed to do that to protect their own sobriety. Eventually they got it all sorted out and started a hospital that still runs today where I get a lot of my work and training and life and career experience. That was not recovery. That was a professional treatment practice.
Then the recovery was a big part of our life even then. The thing that impressed me was that my dad had almost gone bankrupt giving away what he earned in his career after he had gotten sober. Before he got sober, he was taking everything out of the world. I asked my psychiatry professor in medical school, “How does a sociopath change to become a philanthropist?” I had in mind to try to figure this intellectual stuff out.
I was just blown off. My psychiatry professor said, “It never happens. You’re hardwired to be a sociopath. Anyone with that diagnosis can never become a normal human being.” I never had the courage to tell my professor that I was talking about my dad.
I did become somewhat of a skeptic of the medical field at that time knowing that what I had seen with my own eyes was true. There must be things that the medical hadn’t understood or hadn’t explained yet. Sure enough after a lifetime of my profession, I realized that more is revealed all the time about recovery. Now we know about neuroplasticity and we know the brain can be molded into something that it never was. What we read in the AA material is true, this concept of psychic change. Now we have some scientific structure to understand it by. That was really cool to watch that come decades after I learned about it as a teenager with a dad who changed like that.
Casey Arrillaga: Yeah. Even that, what you would call a sociopath still has some popular currency. As a clinical social worker, I’ll say that within the field we wouldn’t use that term anymore. We might say they have an antisocial personality disorder, which is not just a change in terms. It’s the recognition that this is a condition that they have rather than who they are as a person. More importantly, they can recover from that as well.
I think a number of psychiatric conditions including addiction that for a long time not just the word on the street, but also the word among professionals, what was being taught in medical school, what was being taught in social work school, counseling school, and psychology programs is that’s incurable. Unless the advice that was given was you want to separate out the alcoholic, so you don’t treat them. Yet here you are with this personal experience of watching it happen in front of you in your own family, leaving you to say wait, there is a treatment. How do you start to bring those things back together, the science and the recovery?
Dr. Al Mooney: When I realize that medicine was so far off track as a medical student, I knew I had to go other places to get my information. I was hopeful and I’ve been rewarded because now the science of addiction is often not seen, but it’s there. I love getting my nose into some of the scientific and scholarly investigations. Even Alcoholics Anonymous invited those scholarly investigations in its original publication.
For a long time I think it was ignored or there was never a path forward decided on. With just recent research that is out of the Cochrane Library, if people are interested, they can Google Alcoholics Anonymous Cochrane Library and this wonderful research will come up that documents how effective in a scientific way Alcoholics Anonymous has proved to be. The caveat to that because we don’t just throw treatment options at people, but if we pick the modality that targets the right situation that an alcoholic and their family is in, we get a lot better success. This gets very complicated and we won’t have time to get into very much, but there is a time when people are under the influence of alcohol and drugs where I don’t care what we put in their head verbally. It’s not going to sink in because it’s a physical problem that requires withdrawal treatment.
In the words of the Big Book of AA, Bill Wilson called these people jittery and befogged and basically just very quickly said until the doctors get them well and get their head cleared, there’s not much that we can do. He set the stage for the medical profession having a platform to shovel people into AA after getting them detoxed. That when it worked right, it works really well. There also is a concept – it’s in a lot of the AA literature originally.
Chapter 7 talks about working with others. It expresses how important it is to have a bond with another person before you can really share meaningful information about recovery. There are some scientists now that in the 80s discovered a progression of motivational readiness that goes from not even thinking about a problem to thinking about it to making a change.
There are five levels that Prochaska and DiClemente discovered, that actually pre-contemplation and contemplation are the first two early levels. It’s hard to reach people in any way to help with sobriety then. There are interventions that will help move them to a further and higher level of readiness. The 12-step approach deals with the highest levels of motivational readiness. Those three we call preparation, action, and maintenance, and for those people familiar with the steps, the preparation for recovery is steps one, two, and three. You really don’t have to do anything. You just stop drinking and work those three steps. Then the action steps four through nine are cleaning up your life, first your side of the street and then what you’ve done on the other side. At the end of step nine, there’s a change in recovery that was experience in those early people that wrote the AA material and we still see it today as people progress in recovery where they’re what we call recovered. We don’t use the past tense very often but the original people did. Then readiness to change moves to maintenance to keep what you got. That’s 10, 11, and 12 are the maintenance steps in recovery.
However that’s packaged, whatever, 12-step program or recovery fellowship, those stages of healing are important for it to be successful and only early in that process with detox or some sort of engagement in the recovery process has to happen is where the medications have really shown to be effective. They can be very effective if they keep you from having a seizure and dying and there are other expectations from some medication treatment, but once the people are in a recovery path, then a lot of the healing comes from the fellowship, mutual support, insight, and a number of other things than happen as that brain molds into something it hasn’t been before and doesn’t need to drink anymore.
Casey Arrillaga: Great information. I will humbly submit that our own podcast did an entire episode dedicated to the stages of change. That’s Episode 7 for those that want to go check it out. I love how you tie the stages into the 12-steps. I also want to point out that for those who are looking for alternatives to 12-step recovery, that SMART Recovery, which is probably the next largest in terms of the non-12-step group, is based specifically on those same stages of change. They talk about these changes in their literature and how people identify where they are and how to move themselves forward if they’re not where they want to be. It’s a great summary there, Dr. Mooney. I really appreciate that.
Dr. Al Mooney: You mentioned SMART Recovery. It’s important because in America, we have a – and I’ll try not to be too critical of our healthcare system, but it’s really not up to a worldwide standard. One of the problems is that we silo different modalities of treatment. There’s much less holistic care, integration of care, and one method working with another method. There’s a lot of reasons for that that we don’t have time to get into but there are some other societies. The one I’m most familiar with is in England, they have a national health service. They have the ability to integrate methods of recovery. Now, there’s not as much good recovery treatment in England as I would like to see. The recovery movement is strong in England and rapidly taking hold but there are a few national health service districts that deal very effectively with addiction.
What I learned from those, instead of every method being in competition, the SMART Recovery people are out competing the 12-step people and the method on maintenance people got an elbow in a place in the system. The system doesn’t require that over there like we’re all competing for some kind of dollars in our healthcare system over here. What that means in the systems at least that I’ve worked with is that it can be integrated because there may be a time where a person can initially get some medication that we would say in long-term recovery would be destructive if that attracts a person, for example, methadone attracts somebody out from under a bridge and keeps them from getting HIV or dying. Then we’ve got a place where we can help educate them on the readiness for change model, educate them on the steps, and give them examples of people that are doing very well in recovery.
That integrated concept worked really well. What I’ve seen in the system that I was consulting with in England was that SMART Recovery has a little bit more structure and definition that attracts them in more easily. All of a sudden, people move around from one recovery to another, and usually, up the ladder to 12-step recovery but it’s flexible depending on what a person chooses. I’ve seen that that kind of integrated care is less available in the US, even though some of the silos function very well in the US. It’s the integration of different modalities that sometimes we lack over here.
Casey Arrillaga: I appreciate you speaking to that. I am fortunate to work at a treatment center, WindMill Wellness Ranch, where we actually offer both 12-step and SMART Recovery. We have staff who have gotten and stayed sober through SMART and we see a lot of our clients will really embrace both. Some of our clients will say, “I’m just doing 12-step,” and some will say, “I’m just doing SMART,” but the vast majority of people that explore them end up doing both and find that they actually work really well together. I’m encouraged to hear that they’re doing more of that in England. That actually speaks to something where you’ve done international work on different continents and seeing both the science and the recovery in different places. Can you reflect a little bit on what you’ve seen in those travels?
Dr. Al Mooney: I started out about 35 years ago with an iron curtain. There was a terrible problem with alcoholism in Russia. I was invited to participate training some physicians and even going to Moscow to consult with what they call their narcology hospital. They actually had a big hospital that people were detoxed and sent back to the street. It wasn’t effective like we would expect over here but at least they were trying to learn more. That was interesting. From there, I got involved in a project in Romania and then Bosnia-Herzegovina and Egypt. The most recent one was Ghana, West Africa. There was an attempt to get recovery started. It was not much recovery as we would think of and some of the traditional healing for addiction was very interesting and probably more detail than we have time to get into.
The one thing I took from some of the traditional healing was there was a trust of traditional healers. We’re suspicious of everything in America. Hell, we can’t even get people to wear a mask to save their life from a dangerous virus. There’s a self-service independence that we have in America that at times can be dangerous. There are other things that are dangerous in foreign countries but there actually is a trust of the healer in Africa that, even though the methods were very different than I would ever use as a traditionally trained physician in America, that relationship between the patient and the healer is something that I’ve been very curious about and watched and looked for ways to take advantage of as we implement methods that come from ways to help addiction that really do work, calling it a disease, looking at the spiritual element to recovery, because family and faith are very strong in Africa, particularly in Ghana where this project recovery Africa has been.
The American culture nature of AA trying over there was not very well accepted. The principles of recovery, the steps, the spiritual growth, the family fellowship, all of the healthy things seem to be part of the African culture, but what I call Wall Street and baseball, the national culture and history that recovery in America started with, it just doesn’t translate to African countries, or at least in the settings that we were working with. It seemed to impede the development of recovery. I was asked to be involved because I was a physician. My role was to help move people who have alcohol problems and were taken to the hospital into an extended care environment where they could absorb good recovery, including 12-steps and AA or anything that seemed to work.
What happened is that, at first, it was very difficult, and before it got to be a little program with outside help, kind of like even AA started with outside help, from church people and the role of non-alcoholics in starting AA is often under-emphasized but it’s an important element in why AA even exists, why any of these mutual support recoveries even exist. That actually was a factor in Africa development because we’re working with physicians and helping trying to figure out how to get people from a hospital into a recovery environment was slow and not easy but eventually the principles that we know work in recovery seemed to adapt to the culture.
Actually, now almost 60 years, it’s really began to blossom in ways that are unexpected to me. Now with the pandemic and with the technology, we’re actually having a lot of cross-pollination of cultures and meetings and members all over the world. I’ve got a friend in Africa who’s been sober two and a half years and now he’s gotten to be very popular talking at meetings in California. You can do all this in Zoom, which would have been impossible before the pandemic forcing us to get into a new dimension of recovery, which is also important probably to at least mention because a lot of people who are the most mature and secure in their recovery have been broadsided the most with the pandemic and the technology.
I think there’s room for these people who have much less recovery experience to come to the plate with value from their technology experience to help some of the old timers who need to be there for some of the younger people. There’s a whole new universe of recovery that’s opened up because of the isolation created by the pandemic. Now, there are some locations where the opportunity has developed more than it has in other places but at least in my work internationally, and specifically with Africa, it’s just taken off and really fueled a lot of the recovery that the people in the continent of Africa were hungry for.
Casey Arrillaga: That is fantastic to hear. Thank you so much for doing that work.
Kira Arrillaga: We’ll hear more of our interview with Dr. Mooney after a word from one of our sponsors.
Welcome back. Let’s hear the rest of that interview.
Casey Arrillaga: Before we get to the end of the interview, I have a couple of questions I want to ask you, one personal and one professional. I’ll ask the personal one first, if that’s okay. You mentioned that in your journey that when you went off to college, you stopped attending the recovery fellowship meetings so much. What brought you back?
Dr. Al Mooney: A couple of things, and I would participate through my family when I visited. I got involved in some recovery activities. I went to medical school in college in Atlanta and I did some but it wasn’t a core of my life like my education was. When I did my post graduate work in Louisville, Kentucky, is when I got reconnected with my personal recovery. Part of it was because I was working in the addiction field. I was doing a surgery residency and I had an evolving understanding of my capabilities because I loved surgery. I loved the technical part. I just found myself – my whole personality changed to be like a surgeon, expecting results, high level of assertiveness pushing the aggressiveness bar a little bit. I found myself on that threshold.
I had an event. This was one of those life changing events. The professors were all in helping us figure out what to do with complicated patients. One of the residents, the chief resident, the head trainee in my little group, asked our professor, he said, “There’s a group that we’re really struggling with,” and of course, he was talking about the alcoholics. He said, “We bring these people in when they’re gunshot, when they’re stabbed, when their ulcers are bleeding, and we do all we can staying up night after night saving their lives, but then in a few weeks or a month or two, the same guys come back in with the same or a different problem.” Of course, these are the alcoholics. Normal people, when you fix them up from a life-threatening problem, they figure out what the problem is and they don’t jump off that cliff anymore.
My professor said, “I want you to know,” and he stopped the whole group at that time and very assertively said, “If you’re going to be a surgeon, you need to know one thing, that everybody on this earth has a purpose in life and some people are put on this earth to teach surgeons how to operate.” It was like, whoa, because I knew that was in a different universe than my attitude was because everybody I knew who had an alcohol problem had gone into recovery and gotten well and rippled through the family for generations. I realized then that I was in the wrong career path.
There was no field of addiction at that time. It was something I had to invent in my own way, which I did a pretty good job of doing that and then I was involved later as a physician in helping develop the certification for physicians in addiction. I’m very proud to have been on the board of American Society of Addiction medicine back then because these life and professional experiences guided me. That was what it was like. I ended up getting involved in my recovery path.
Then when I got into my medical practice, I had another decision point. There was some personal issues with a family. I had to ask myself I’m going to be in this community as a doctor and a difficult decision for me to join a mutual support group at that time with the pride and arrogance that comes with being a highly educated framed physician. Somehow, the humility to go into a meeting with patients and with people that were suffering in the same way I’d suffered in the family was a difficult decision. I bit the bullet and I did it by saying I don’t have to join this recovery fellowship forever. If I’m going to be in family recovery, I can do it one time and then never go back, do it a month, do it a year. That was in the late ‘70s and I continue to depend very highly on my personal recovery and those meetings. I never decided to go forever. I just decided to go one meeting one week at the time and it just never stopped.
Now, there are some things, and I haven’t talked a lot about my book, The Recovery Book, but in writing my book and in doing my professional development, my contribution has to do with the developmental aspects of healing from addiction and a person in the family. I’ve discovered that that initial foundation of building a recovery where I have to be open-minded, I have to observe a lot, my opinions probably don’t matter that much because they’re tainted with my own pain and suffering and misinformation. As I continue in recovery, the intellect and the education and my curiosity to learn more have become very important in my speaking power.
A lot of people come to a few meetings and feel better and I never see them again. That’s not happened with me. I am just as passionate about what’s around the next corner as I’ve ever been and I’m very grateful for that. I also have to realize that there are phases of development. I call those zones, red, yellow, green. Even when I have hard times, and most of the time I live in what I call the green zone doing all I can to carry on the message, live as long as I can and help others. When I’ve had some close family experience with addiction or when I’ve a couple of times been physically and mentally exhausted and even one time with some surgery needed medications, I find myself, even as a family member in recovery using my own principles of The Recovery Book to retreat back to a more basic level of recovery in the red zone or the yellow zone. I won’t get into all the explanation but that developmental aspect offering a retreat back to a more basic level has been an important part of my own recovery path and probably the one major thing that I hope I’ve offered to others who have a lifelong interest in recovery.
Casey Arrillaga: You’re leading beautifully into my second question. On a professional level, where can people find your work, learn more about you, and find that book you’re talking about?
Dr. Al Mooney: The name of the book is The Recovery Book and it’s in every major bookstore. It’s published by Workman Publishing in New York so they have a wonderful distribution path. Also Google Al Mooney The Recovery Book and usually it’s the first thing that pops up on Amazon or Barnes and Noble or anywhere you buy your books. One thing we haven’t mentioned that I think is important that we tried to do in the recovery book is because there's so much touchy-feely stuff that’s important but you might be looking for medical information. The Recovery Book, the first chapter is a little bit about the brain and how the brain can heal after it’s been sick from addiction. I encourage people to read chapter one, chapter two, and then if they like what they read, then move into the rest of the book, which is a blueprint for healing over a lifetime.
Casey Arrillaga: Thank you so much for writing that, for all the work you’ve done to help individuals with addiction, families with addiction, and family members, and for putting that message out there to families. You talk about a lifetime of recovery and that’s something you seem to have modeled really well. We’re going to move towards closing. I’ll ask, is there anything else you want to say to family members out there?
Dr. Al Mooney: Yeah, I want to encourage family members to keep hope and that it’s not always stared us in the face. It’s out there but I wanted to thank you and tell you how important it is for a message of recovery to be out there. One thing that we who have experienced recovery hope to do as we move through this journey is to share the hope of recovery with others. In the world we live in that is based on your money moving to somebody else’s pockets, there’s very little of a market economy that fits with this recovery.
Nobody makes any – as a matter of fact, people probably don’t have as many medical bills and extra bank fees, all the things that keep our economy turning go away when people get into recovery. Not all of it but a lot of it. Then you have money to buy presents for your grandkids and all kind of things but there’s very little economy in recovery. That distresses me but it also means that those of us who have been given that gift can participate in sharing it with others who might not have been as fortunate yet but who deserve the hope and opportunity that recovery brings into our lives. I hope that there’s a message that can get to people where they can find recovery. Then please, when you find it, grow in it and pass it on to others because it’s not going to be something you can go down to the grocery store and buy, like almost everything else in life.
Casey Arrillaga: Beautiful. Dr. Mooney, thanks so much for being on Addiction and the Family. It’s been a great pleasure. I hope we’ll be able to have you back sometime.
Dr. Al Mooney: Thank you, Casey. Thank you so much for the message you’re working so hard to get out to family members who can do so much good for themselves and for those people they love and to society in general. It’s good to have a partnership with you and all the people you reach.
Kira Arrillaga: That’s our interview with Dr. Al Mooney. His book, The Recovery Book, is available wherever books are sold.
Casey Arrillaga: Thanks for being with us through another episode of Addiction and the Family. As they say in many recovery meetings, take what you liked and leave the rest. Go out and explore the possibilities for recovery in your life and give your loved ones the space and dignity to make their own choices.
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Kira Arrillaga: Addiction and the Family is produced, written, and engineered by Kira and