Like you, I have prayed and agonized over the tragic Heather Cook situation. Like you, the night I heard about it, I lay awake, praying for the family of Tom Palermo, picturing what Heather Cook must be going through at that moment, wondering what I would do and feel if I had done what she did. Like you, I have watched in distress as more and more of the story has unfolded – what did her two diocesan bishops (Easton and Maryland) know and when did they know it, who knew about her prior DUI, how could such information have been kept from the electing convention, what should the Presiding Bishop have done and what in fact did she do, how could our church system have failed in selecting and supporting a leader at every step of the way, from the first DUI to the bishop search process to the pre-consecration dinner to whatever happened afterwards?
Like you, I have wished we could go back in time to 2010, when there was still time for Heather Cook to deal with her addiction. And possibly like you, I am completely unqualified to know what the church should have done, because I don’t have that much experience with addiction, beyond the basics I’ve picked up as a parish priest.
And yet, perhaps like you, I am the leader of a congregation, and perhaps like you, I may one day have an addicted employee, and will need to know what to do about it. So, as naïve and uninformed as I am, I realized that I needed to find out more – not about the Heather Cook situation, which I am not qualified to judge – but about our church system, and about how we should be dealing with people with addictions who can cause great harm to themselves and others, and to our church.
Anna Marion Howell has written a lovely reflection saying that Heather is a child of God, and in our Christian compassion, we should be loving her, not judging her. I couldn’t agree more. But I also think as Christians, our mission includes healing. Wouldn’t it have been more compassionate, though more difficult, to try to convince her to go into recovery before she killed a man, than to simply love her afterwards?
Convincing an addict to go into recovery, however, will almost certainly require “tough love.” One of my friends, an addict who has been in recovery for decades, says that we as Christians cannot possibly heal an addict. It is up to the addict to take responsibility for her own recovery. My friend writes: “What an employer, church or secular, must do is document behavior and, when well armed, give an option of the person entering treatment or termination. You can’t fix it. You are not responsible for it. What you are responsible for is ensuring that those people that are supervised by you do their work and are not putting others or the institution at risk.”
So, let’s say you are the supervisor (bishop, rector, lay supervisor, etc.) of a bright, talented, enthusiastic employee who has great potential. But you suspect that the employee has an addiction problem – with alcohol, drugs, gambling, sex, or any of a number of other addictions. What should you do about it?
I interviewed the Rev. John Christopher, a priest in the Diocese of Arizona who has been in recovery for many years, and who will soon become the diocesan recovery officer. I also interviewed a couple of others who prefer not to be named here, and I’ve used their insights as background information. I learned a lot from these conversations. Read on if you’re interested.
What trouble signs should you look for to determine whether someone has an addiction problem?
My recovering friends say to look for irresponsible behavior: coming in late, missing appointments, calling in sick frequently, unexcused absences. Look for relationship problems, financial problems, and other such concerns that should raise a red flag for an employer, whether the person is an addict or not. Keep an eye on the person who is always providing the wine, and who seems to think that alcohol is appropriate for any occasion (church business meetings; Sunday morning; etc.). Notice when someone consistently seems to grow anxious as cocktail hour approaches. Be aware that there are more addictions than just substance abuse – for instance, a huge pile of credit card debt could be a sign of a spending or gambling addiction.
John Christopher says:
If they already have a history of DUI, or they often leave early or come in late, that could mean a problem. If you smell anything, see odd behaviors, those could be indicators. I’m talking about more than just going out and getting drunk once; if these are persistent behaviors, it could mean they’re an addict. It’s not appropriate if you see them taking a drink at work from a bottle in their desk. The longer you drink, it starts to come through your pores, and you can smell it in their perspiration. As much as alcoholics and addicts think they’re fooling everyone, they’re really not. Always remember about a using addict: the further along they are in their addiction, the more that is their number one priority in life, no matter what they tell you. And their second priority is not getting caught. They will do whatever they have to do. Especially in our world, an actively using addict just puts up a wall between themselves and God. You’re lying to yourself, your family, your boss – you can’t be spiritual that way.
What should friends, supervisors, etc., do to convince an addict to get into recovery and to keep them accountable? How should people in authority deal with a person who is very talented and capable but who clearly has an addiction problem?
My recovering friends say that these are issues we need to address with relentless honesty, demanding accountability. The compassionate thing to do is to hold an addict responsible for her recovery, because the consequences of not holding her accountable are much, much worse. It’s a difficult step to take – to call someone on an addiction problem – but dealing with difficult problems is one of the reasons we give authority to leaders. Supervisors can insist on a professional substance abuse evaluation, not just a general psychological evaluation, and they can insist on receiving assurance that the employee is following a recovery program. And if the employee won’t do the work of recovery, the employer can’t make him – the addict is responsible for his own recovery. But if he won’t do that work, the employer must terminate him, for the sake of the addict, who is not doing himself or the church any favors, and for the sake of the church.
John Christopher says:
We live in such a polite world in the Episcopal Church. We say, ‘I like her so much, maybe she’ll straighten out.’ No one wants to be the bad guy and blow the whistle. But we need to. The first thing, if they have not addressed it, the [supervisor] needs to say, ‘You have great potential; however, you have a progressive disease that can only get worse. We can’t afford to see that happen. The number one thing is your health. You have a terminal disease. If you are not going to do anything about it, we’ll have a different discussion.’
People in recovery have no problem with random drug tests or turning in attendance reports for meetings. At any AA meeting, someone will come to the leader and say, ‘I need you to sign my meeting report for the police, my probation officer, my employer.’ You should track whether they’re going to meetings. Their sponsor should be willing to comment without disclosing details: ‘We are continuing to meet and work on things,’ or ‘I haven’t seen him in three months.’ If the person is really in recovery they won’t complain. For me, the more people that know you’re in recovery, the more it’s a safe harbor for you. If the person seems to be doing really well it becomes a way of encouraging them, when they’re working a recovery program, living one day at a time based on their spiritual condition for that day. Most people truly in recovery have had a change in heart. If they’re truly working recovery, they’re not afraid to talk to just about anybody about it, unless they work for someone who would fire them. But they’ll share with plenty of other people.
Sobriety becomes the number one priority. It has to be – if you don’t have it, you’re going to lose everything anyway. As human beings, we need to first be concerned about the person’s welfare.
Compassion – for the addict and for those he or she could harm – compels us as Christians to hold our sisters and brothers accountable for their own recovery, even if it means unpleasant conversations and difficult accountability structures. If they refuse or relapse, they should not be allowed to take on or keep responsibility in the church, no matter how much we love them. Love means supporting them in their healing, not enabling their continued addiction.
If you were on a rector or bishop search committee, what kind of questions would you ask to determine whether there is an addiction problem?
My recovering friends say to ask directly about alcohol and drug history; ask whether dealing with substances has ever been a problem, and if so, what kind of recovery program they are working. How many steps have they worked? Do they have a sponsor? Are they a sponsor? How long have they been clean? These questions can be part of a whole conversation about spiritual disciplines. Ask their references for their observations about the person’s use of alcohol and drugs, boundary violations, money habits, etc. Make sure the person knows that you are going to follow up with their references about these questions. Pay attention to things that don’t ring true, or to areas where the person seems to be protesting too much. If a person has had a DUI, that’s an indication of extreme behavior, and the search committee needs to know how they are following up – have they had a substance abuse evaluation, did they check into a treatment center, etc.? If they are not willing to be public about their recovery, that should ring an alarm bell, because people in recovery usually are willing to talk about it – the recovery process is generally one of the defining spiritual crises of their life.
John Christopher says:
Check the legality and make sure it can be asked. But I wouldn’t have a problem asking about their history with drinking and drugging. Ask their philosophy on it: how do you feel about it, how would you handle a parishioner you knew was causing problems all the time? I think in search committees it might be important to have someone in recovery, even if just for that part. They will pick up cues others don’t, they will pick up if the person has a skewed perspective, even language others wouldn’t use that a person in recovery would pick up on. Any really great addiction specialist can develop questions for a psychological evaluation, and you can get a good indicator.
What kind of organizational structures in the Episcopal Church would help in dealing with addiction issues?
We may have a cultural issue as much as a structural issue. Our reputation as hard-drinking folks in many cases is well-earned, and it doesn’t make things easy for addicts who are trying to stay sober. We should all be evaluating whether using or serving alcohol at church events is appropriate, and what kind of jokes we should be telling about ourselves. If our jokes reinforce a self-image that could be destructive, maybe it’s time to stop telling them. As John Christopher says, “Remember too, it only takes one person to cause an incredible amount of liability; it only takes one person to wipe out a van full of kids.”
My recovering friends suggest that each bishop should know of a professional substance abuse counselor to whom the bishop and diocesan clergy can refer people who might have a problem. This counselor could operate through a kind of Employee Assistance Program, whom clergy and lay employees of the diocese could contact confidentially. John Christopher suggests that a diocesan recovery point person could also visit every church on a regular basis, offering education and support. He proposes that each diocese should have a person to call, who will keep confidentiality and meet with you. Someone could tell me what they observed, then my job is to confidentially go meet with that person and say, ‘There’s been a concern raised here.’ It puts them on notice, and some may say, ‘I just have to hide it better.’ In some cases if it’s bad enough then I might have to say, ‘If you’re not willing to talk, I have no choice but to tell the bishop about behaviors people have observed.’ We have to have a place like where they can go and it’s safe to ask for help for themselves, or report someone else. Then I go to them and say, ‘There’s an easy way and a hard way. If you admit you have a problem, I will work with you and be your advocate. Don’t wait till you get caught in a bad situation.’
Church-wide, we could have similar point people to call – perhaps a group of people located around the geographic breadth of the church. These people would work with bishops and church-wide employees on recovery issues – both for themselves, and advising them on how to deal with diocesan clergy and employees who might have addiction problems.
As John Christopher says, “You’re not responsible for your disease, but you are responsible for your recovery. You need a lot of people around you.”
This problem is real, and it extends far beyond Heather Cook. One of my recovering friends says, “Addiction almost killed me through ODing, totaling a couple of cars, and getting myself in some very dangerous situations. I am grateful that I never killed anyone. I know people who have, several. This is real life. Being ‘kind’ or assuming responsibility is not any supervisor’s job regardless of the work setting.”
I hope we can get better at this. I hope we can start having the tough conversations and insisting on accountability from our lay and ordained ministers. I hope and pray a situation like Heather Cook’s never happens again.
For the Victims of Addiction (BCP, p. 831)
Blessed Lord, you ministered to all who came to you: Look with compassion upon all who through addiction have lost their health and freedom. Restore to them the assurance of your unfailing mercy; remove from them the fears that beset them; strengthen them in the work of their recovery; and to those who care for them, give patient understanding and persevering love. Amen.
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Excellent article. Thanks for posting. All supervisors, not just church people, would benefit from reading this.
I write as a psychologist with nearly 40 years of experience. This is a well-intentioned piece, but unfortunately, it does not reflect the state of knowledge in the field of substance abuse treatment. The lay public have accepted the idea of substance abuse as synonymous with addiction and dependence. They also accept the progressive/disease model of addiction. As we have seen with most of the commentary on Heather Cook, the majority of people assume she was/is an “alcoholic,” i.e., has the “disease” and is alcohol dependent. Even her lawyers are apparently saying this, because this is the language and the concept that people understand. However, it may well be that Bp. Cook’s pattern of abuse was episodic, and that she drank moderately most of the time. This requires us to think differently about the varieties of substance abuse and treatments. There is, for example, evidence to suggest that traditional (and hugely expensive) 28-day residential programs are not very effective with a large percentage of people who go through them. Although it may seem heretical to say it, abstinence is not always achievable or necessary. AA and/or 12-step programs don’t work for many people. There are other treatments, based on behavioral approaches, that offer better outcomes for many, enabling them to control their drinking and avoid harm. So long as we continue to understand substance abuse as a progressive disease that requires one kind of treatment, we will continue to spend phenomenal amounts of money supporting a treatment industry and approach that does not produce reliable outcomes. It also means, sadly, that people who could benefit from more effective treatments won’t get them.
Thanks for your comment, Harry. I hope I made it clear that I was not writing specifically about Heather Cook – I don’t have enough facts to judge the behavior of the folks involved in her case, or her. I will note that it seems to me that her very high level of BAC, both times she was arrested, seems to indicate a long-term habit building up a huge tolerance to alcohol. But you would know more about that than I would. I can’t judge whether she is an alcoholic, one way or the other. But that’s not the subject of this piece – I am truly writing from the standpoint of someone who doesn’t know much, supervising an employee about whom one has questions. What questions should be asked, what kind of follow-up should be insisted upon, and who should be consulted? I would hope that experts who reflect “the state of knowledge in the field,” as you say, would be consulted, and that each bishop and clergy person would have such an expert to call upon to do an evaluation. Whether the recommended response involves a treatment program or some other kind of treatment is beyond the scope of my article, or my expertise. Thanks for your comment.
Thanks, Susan. I wasn’t really wanting to focus on Heather Cook, per se. Perhaps I was overreacting to the many references to “addiction.” The point I was trying to make is that there are varieties of ways in which people can be harmfully involved with substances, yet most people have only one lens through which to view substance abuse: the dependence/progressive disease model. For those of us who are concerned about how to help screen aspirants and advise Bishops (I have been the examining psychologist for 2 dioceses in upstate New York for the past 15 years), I’m hoping that Bp. Cook’s case might lead us all to a more nuanced understanding of substance abuse and its treatment.
Got it – addiction isn’t the only kind of substance abuse, is what you seem to be saying. Periodic binge drinking can also be fatal, for instance, if one has poor enough judgment to get in the car and drive. A substance abuse evaluation should look at that issue too. Thanks for that helpful point.
Harry Merryman, AA and 12-step programs seem to work for some who have problems with substance abuse; rehab seems to work for others; and behavioral therapy works for yet others. Are there good comparative studies for success rates for the three approaches to treatment for substance abuse?
June: I also posted this to Episcopal Cafe. I agree with your point about different people responding to different treatments.
In answer to your specific question, the National Institute on Alcohol Abuse and Alcoholism (NIAAA, part of the National Institutes of Health) reports the following:
“. . . scientists are examining whether certain patient characteristics predict better responses to different approaches. Although no such patterns have yet emerged from research, core components of effective therapies have been identified that may prove useful in helping a care provider decide which treatment is best for a particular person. These components include enhancing social support, working with the patient to develop goals and to provide ideas for obtaining those goals, modeling and rewarding good behavior, and reviewing ways to cope with the triggers that lead to drinking. Matching a patient to therapies that address an area where he or she shows the greatest need may prove most effective.”
My experience has been that high functioning and highly educated people are often not good candidates for treatment programs that stress the disease model. These folks seem to respond better to the “harm reduction model.” This approach stresses engagement with substance abusers in designing strategies to reduce the potential harm that may result from their use. As opposed to the disease model, where any use is seen as leading inevitably to loss of control, harm reduction is an empowering approach that teaches people strategies to control how and when they use in order to minimize potential harm.
It must be stressed, however, that this approach is not for people who are truly addicted, i.e., alcohol dependent. For them, abstinence may be the only way, and AA and other 12-step models are probably the most appropriate.
Harry: While I completely agree with your opinion that ‘spin-dry’ 28 day rehabs are not very effective, I am very concerned with the message you are sending alcoholics that ‘complete abstinence may not be necessary’. IMHO, that is a very dangerous I believe, from personal experience’ that the message your sending actually puts lives at risk. Back in the late 80’s I had been in recovery for alcoholism for several years. A report surfaced that indicated that ‘some alcoholics might be able to return to social drinking’. Well, I figured I might be one of them and started to drink again. I was committed to moderation. Within a month and half I had caused a wreck that caused the death of a little girl. If anyone understands what Heather Cook is experiencing, I do!
You also mentioned that Heather Cook might well have been drinking in moderation and simply (although you didn’t use the words) binge drinking occasionally up to the point of the accident. Again, IMHO, that isn’t possible with the BAC she sported after the accident. She has been drinking heavily and doing so for quite some time. You also mentioned that the 12 steps don’t work for everybody. I have never known someone that failed to stay sober that honestly worked the step. They work if you work them. I have been working as a substance abuse counselor for the past twenty-five years and the vast majority of success stories I have witnessed are from people who work 12 step recovery.
Walter: Thanks for your message. I wouldn’t disagree with your observation that people who are truly “addicted” (i.e., alcohol dependent) may need to abstain from use. In fairness, I don’t think I was encouraging alcoholics to abandon abstinence. My point is that when people are found to have an alcohol abuse problem, the assumption is often made that they are “addicts” suffering from a “progressive disease.” This definition leaves only one treatment alternative. When we understand that harmful involvement with alcohol can take different forms and results from different causes, we open up the possibilities for more successful treatments.
This isn’t true for everyone, of course, but NIAAA has found that a large percentage of those who recover from “alcoholism” do so without assistance, often returning to a pattern of moderate, controlled drinking. This also applies to a substantial percentage of people who have gone through 12-step programs and have been in, and subsequently left, AA. You can access the studies on their website. As indicated above, we have a lot to learn about which treatments are effective with which people and forms of abuse.
With regard to Heather Cook, BAC level and its effect is quite variable from one individual to another. But assuming you’re right that she must have been abusing regularly to blow a .24 (I believe it was) does not obviate the point I want to make. In fact, I believe I read that she underwent treatment following her first DUI in 2010. Although *I do not know the nature of the treatment she received* my guess is that she went to rehab, got dried out, and was encouraged to work a 12-step program. I do not want to say that her subsequent DUI could have been prevented had a better assessment and treatment matching process been followed. There may have been no treatment that could have prevented this tragedy, but obviously, the treatment she did receive did not prevent it. I’m only suggesting that we need to open our thinking to include other methods that do not rely on a disease/abstinence model. Focusing on harm reduction, for example, is one such approach.
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The issues of Addictions in the Church are not new. There is the 1979 General Convention Resolution that addresses and recommends steps for the National Episcopal Church and every one of its Diocese to follow, and few have. The National Episcopal Coalition on Alcohol and Drugs (NECAD), now Recovery Ministries of the Episcopal Church have consistently since 1979 provided education and Intervention support to Diocese and clergy who requested it. The Church Pension Fund in the past during the 1980’s formed, trained and provided a national network of Clergy support through an “Employee Assistance” program (EAP). I was one of those EAP Contact individuals who was contracted by the Church Pension Fund to be available by pager and telephone to provide assessment, referral and support for distressed clergy. Issues of alcohol problems/ dependency, emotional and metal health problems, serious physical illness and sexual misconduct were addressed by these counselors. That said, the program was ‘supposedly’ folded into the new negotiated clergy insurance program and the contracted EAP counselors were not continued after about 18 months of service. The EAP counselors were EAP Professionals, not clergy, though we had clergy consultants and we were all recruited through NECAD. Alcohol Awareness Sunday is an event promoted by Recovery Ministries that every congregation in the Church should experience ANNUALLY. Every Diocese should have a Commission on Alcohol and Drugs to advise, support and education congregations and clergy about how, when and what to do to assist those ‘afflicted by addiction’. Read Prayer 56 among the prayers of the people this Sunday.
Kerry Fitzgibbons, Diocese of Olympia layman
I’m with Walter. It was the church that called out my alcoholism 30 years ago, as a result of which I got sober in AA. Just an anecdotal response here, but both the church and a 12 step program were lifesavers for me.