Poonam Hemlani earned her M.A. in Counseling. This observation paper was written for Dr. Baza's Group Counseling course.
I am fortunate to have had the immense pleasure of observing a session at the Hafa Adai Alcoholics Anonymous (AA) group on Guam. Alcoholism may be described as patterns and habits pertaining to drinking. Because alcoholism is regularly coupled with impulsivity, the immediate gratification providing the equally immediate guilt is a decipherable pattern. The adage, ‘one must be sick and tired of being sick and tired’ seems applicable to muster the colossal willingness to change one’s life. Initial thoughts plus preconceived notions included the stereotypical drunkard proclaiming his/her poison as an elixir to ward off the pangs of human beings, well, being human.
The exchange between new-comers and old-timers was intriguing because albeit under the same cultural umbrella of ‘alcoholics’, there was a divisive perception of foreign or familiar. I suppose ‘alcoholics’ may be generalized as an assembly of shared knowledge with distinctions amid length of sobriety, whereas comparing and contrasting helps to learn unity in diversity. This may also denote one of the many examples of cultural pluralism evident on Guam; the assimilation of practicing and accepting, sans judgment, a cocktail of coexistent lifestyles.
Upon partaking in this activity, instantaneously the film ‘Leaving Las Vegas’ popped in mind. I remembered Nicolas Cage played a riveting role for surely, and I found the following dialogue particularly telling of his character, Cage slurs, “I don’t know if I started drinking ‘cause my wife left me, or my wife left me ‘cause I started drinking...” The movie goes on to depict scenes in which Cage, the suicidal alcoholic, reluctantly foregoes his habitual fermented grape drinks at whine-o- clock post a near-death convulsion fit. Despite spent generalizations and oversimplified stereotypes, the Hafa Adai AA group served as a salient reminder that no two stories are mirrors.
Earnest attempts to empathize with members in this setting rendered my efforts futile. Reason-being was, I found it difficult to wrap my head around how a person would rely on alcohol to the extent of having such dependency constitute a full-blown addiction. I understand that alcohol is a depressant. So, the logic to choose to consume a drug that lowers neurotransmission levels, which is to depress or reduce arousal or stimulation, in various areas of the brain, to the degree of becoming an alcoholic is nonsensical.
However, I also understand that we are all addicts. Our addictions include exercising, pyromania, video games, gambling, food, pornography, shopping, nicotine, working, phones--we have have our vices. Therefore, to take the stance of self-professed experts spewing sermons of how best to live life is purely fruitless. This concept of cognitive bias occurs when we use unconscious influences or mental shortcuts to form snap decisions versus adequately investing evidence.
To be clear, the physical to psychological effects range from brain shrinkage, damage to the heart, erectile dysfunction, loss in bone mass, ulcers, fatty liver, mood swings, memory loss, increased anxiety/depression to the eventual demise of self. Alcohol can be deduced as yet another distraction, a cop-out, an escape, a time-eater. Alas, human nature is such that at its core we would do anything to relieve ourselves from pain—who are we to judge?
Rules of the session included no cross talking and allotting 5 minutes to share so as to give everyone ample time to speak. There were approximately 15 members, the facilitator was also a member which I found super fair as it made for an even-keel, takes-one-to-know-one type of interchange. The topic for the evening was ‘Came to Believe’ in connection with the second step of the 12 Step program which states, “Came to believe that a Power greater than ourselves could restore us to sanity.”
The session commenced and culminated with the serenity prayer, all together we prayed, “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.” The facilitator read aloud the inscription of a blue sticker on a donation basket, ‘One day at a Time’ to which members reciprocated with repetition or responded with a knowing nod. The book ‘Came to Believe’ was available for everyone to read along, members were asked to take turns reading a paragraph from Chapter 13. Before speaking each member introduced themselves with the standard ‘My name is ___________________, and I’m an alcoholic’ script.
It was endearing to hear such humbling honesty in the tales shared. The richness of memoirs do better to provide insight of this population that scientific journal articles and academic books just cannot entirely grasp. One member made mention of trials and tribulations relating to a passage, and how he Came to Believe by way of GOD, describing GOD as an acronym for, ‘Good Orderly Direction.’ I absorbed that sentiment and determined I could dig it.
Another member expressed how all-consuming the ‘disease’ (dis-ease) was in terms of being a slave to it; drinking sessions revolved around rationing food and allotting paychecks merely to wet the whistle. “I’m not just—hey, let’s take two shots and go home kind of person. No! Not me. I don’t know how to nurse, no way. See, if I have a beer then I’m just one or two or three. Then just—gulp it down all the way,” the member whilst mimicking the motion of polishing half a six-pack continued, “Then it was like, I didn’t have no more funds for fun”.
With chapter prompts of personal struggles, coping mechanisms, and strength, one gentleman spoke of his transition from Hawaii to Guam. At some point he was rendered homeless and deliberated regret for putting himself in that position, “I was on the floor with the electrical cord still around my neck, my knees were bruised. It’s the second time I attempted, and I thought, what will my kids say about me?” He went on to acknowledge the social needs in Maslow’s hierarchy including love, acceptance, and belonging, “I’d be up at 3:00 a.m. calling my friends, asking them ‘what do I do’, and they said, go to sleep. I couldn’t sleep…See that homeless guy in Tamuning, getting mad at the tree, yelling at the tree?! I saw him and was like ‘that’s me, I’m that guy’. He also spoke of how his drinking made for topsy-turvy perceptions, “I would get there [at a bar] when it’s happy hour and stay all the way ‘till closing. I told the guy next to me to stop drinking my drink. I thought this guy was drinking my drinks. He was like no bro it’s you, you’re drinking your own drinks. So, I didn’t know. I didn’t know who even drank my drinks.”
Alongside ‘I know that feel, bro’ assortments of recognition, both voluntarily and mandated members expressed how over time they have come to appreciate the group. Forming such an alliance proved to boost motivation to abstain and accountability of drinking habits. “I was only coming here for the sake of getting my papers checked for my parole. I was selfish, judgmental and thought everyone at these meetings is a liar,” this lady continued by discussing how the fear of hurting someone or herself played a decisive part in her road to recovery.
“I was known as the party girl. I would be out all-night drinking; I came back at 6 in the morning and just keep on drinking until I blacked out. Even my other half said he’d watch me sleep for 11-12 hours and roll me over because he was scared. He was scared I would choke ‘cause I would black out and be coughing and I would vomit. So, he had to make sure I didn’t beat him up or I didn’t die. So I realized what I put him through and yeah, I f#(%ed up. But I’m here and I’m thankful.”
Said lady also discussed how at first, she would cover-up her AA comings and goings because of either peer-pressure or embarrassment. “I lied to my friends and told them ‘I can’t go out tonight; I have math class. Then after 6 months, 18 months…I wanted to celebrate, I said yeah, I’m gonna’ get a bottle of Tequilla Rose…and you know, I couldn’t bring myself to do it. So, I started telling my friends no because ‘guys I’m doing it for myself. I’m going to AA’, ‘cause, what if they ask when my graduation from math class is?!”
With that, waves of laughter in wistful nostalgia ensued assertions of having finally crossed paths amongst kindred spirits who can truly empathize with the plight of sobriety. “It makes me feel better, I miss you guys when I don’t show up. I miss the hugs and sharing,” The lady noted how the group would keep her grounded and how being absent affected her mood otherwise. “When I was stressed out, my other half would say ‘I think you should go to your meeting tonight, you’ll feel better.’ And he’s been with me for 18 years, so he’s seen me at my bad and he knows this makes me feel good.”
The Hafa Adai AA session was a well-received field-trip in that it served as a guide to being more culturally competent by recognizing self responsibility (response-ability). Culture is often defined as the combination of language background, traditions, ethnicity, religion, values, and beliefs that come together to inform many aspects of a person's identity. The process suggests practitioners take on the role of learner while inducing ethical integrity. It’s a good reminder for clients and counselors alike to understand we all have a choice.
This awareness allows us to advocate for our clients when the behavioral health system perpetuates myths that keep them in oppressive pigeon-holes. For instance, treating alcoholism as an illness versus a coping mechanism towards intergenerational trauma, stressful environments, peer pressure, and/or social injustice. Demographic characteristics to also consider are race and ethnicity, sexual orientation, age, gender, disability status and more complex issues such as microaggressions and oppression. Plus to really listen when clients use certain dialect or words as they are being their most authentic selves. Central to effective practice is self-awareness, cultural humility, and the commitment to respect individual storytelling.
By making time to ask the right questions, a better informed counselor determines how addictions affect the lives, health, and wellbeing of their clients. We as interested students receive the formal training on diversity-related research and practice issue in the multicultural and global work setting. Without a culturally competent therapist, therapy may be difficult for many historically marginalized groups that face challenges such as economic barriers or stigmatization about going to therapy.
Becoming a culturally competent counselor is an ongoing process of building relational bridges that engender trust and confidence. Clients enter treatment carrying core schemas and beliefs shaped by their cultural roots and day-to-day realities. A culturally competent counselor would recognize, legitimize, and validate any clients challenges to enter and continue in treatment. Tenets of sound therapy provide sensitivity to the client's personal perspectives, empathy, humility, respect, and acceptance. Engaged counselors actively listen to tales, re-analyze challenges, and create culturally responsive treatment plans.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2022 Poonam Hemlani