One step forward and...... FIRED!

My partner and I were conditionally fired from couples therapy last night. Well, actually, SHE was conditionally fired, but since it's pretty difficult to do couple's therapy alone, the effect is the same.

I know she's confused. She has been stepping up lately. She took care of me when I was sick, and she got her step 1 homework completed.

But, she was agonizingly passive aggressive in therapy yesterday throughout the entire session, and the therapist had had enough. He asked how many meetings she's been going to. She had committed to her sponsor to go to 5 a week after the last time she picked up a white chip in the beginning of November. I don't think she has yet to honor that commitment, and she hasn't told her sponsor that she's not doing it. The therapist told her AGAIN that she does her best work in therapy when she's taking good care of herself by going to lots of meetings. He said that he felt like he was in a session with a 6 year old, and he just can't do couples therapy that way. He said that he sees me getting healthier and healthier, and if she doesn't make some changes, he thinks I'll leave her. He said that he won't continue with us unless she goes to 5 meetings a week. She said she'd discuss it with her sponsor. It was hard hearing her not be willing to do whatever it takes for our relationship. It's interesting timing, because she's also been conditionally fired by her individual therapist for a couple of weeks now, because she's been choosing not to submit insurance papers for YEARS!!! She agreed during our 3 hour session with HER therapist not to go back until she'd submitted the paperwork. That was the beginning of December, and she just hasn't gone back.

I'm trying to stay in the moment and take care of me. Last night, our meeting topic was Live and Let Live. After the meeting, I went out with my sponsor and sponsee. I can't make my partner's choices for her. I can only make my OWN choices. Just for today, I'm going to work really hard on keeping the focus on ME!!!

Partner Stepping Up

My partner seems to be starting her step-work in earnest today. She got herself a new sponsor a few months ago, and then at our therapist's urging, she asked for a deadline. A couple of days ago, she started making comments, INDEPENDENTLY, that she needed to get started, because her deadline was coming up. Today, she pulled out her book, and disappeared.

As most of my experiences in recovery, this is not on my timeline. I, like many of us, used to fantasize about my partner reaching step 9 and making amends to me. I felt I was owed amends. I know today that that expectation meant I wasn't ready.

She'll get there or she won't. She's not doing it in my time or in my way, and today I get that she's not supposed to. I have hope today, because I see her stepping up in new ways,both in recovery and in our relationship. She's doing it on her own and not as a reaction to me. I see how transformative the steps are in the lives of all of the people I see working them, and I want that for her. Ok, I admit, I want it for ME, too. I hope that the changes in her life will transform not only her, but our relationship as well. But today, it's a hope rather than a demand or an expectation. I'm ok with where we are today. I have tools and choices that I can use and make, when I'm not ok with where we are. I think it's not such a coincidence that I'm getting ready to start step 12, and that I really have had a spiritual awakening as a result of these steps. I wish the same spiritual awakening for her. And, if you're reading and recovery is something you want in your life, I wish the same for you. Peace!

Conversations with God- Kidney Stone Edition

My stone was blasted to bits on Monday. I'm still peeing the bits out through a strainer. Fun times. I was doctor ordered to bedrest for 24 hours and then work as pain permits till December 31.

So, God and I had a conversation on Tuesday night. I asked for God's will for me and asked for a clear message, because I often get confused. God answered with throbbing pain at 4:30am requiring narcotics. That meant I couldn't drive myself to work on Wednesday. After I took the pill, it throbbed just a bit harder for a bit so God could let me know that I got the message right. Thanks, God!

So, last night, I told God that I'm listening now. You can be a bit more subtle if you want to, and I'll try to pay attention. Last night, no pain, and I've had no narcotics since yesterday afternoon. This morning, I got ready for work, listening to my body and to God. No pain. Off I went. I realized when I got out of the neighborhood that I'd left my nausia meds at home. As I pulled into work, I was nauseous and sweaty. So, I started talking to God. Ok, God, I'm listening. Can I just go in and get a few things done first, though? Hmmm, is this my will or yours. Oh yeah, the power to carry that out. God, will you give me the power to carry out your will please? After about an hour, I went home.

Hmm. Wonder how our conversation will go tonight and tomorrow.

Knowledge of God's Will for me and the Power to Carry it Out

Our step group is on Step 11. Meanwhile, there's a situation brewing that's not about me but surely is affecting me. I have done absolutely everything I can do to help a kid in my life. But, she doesn't appear to be ready for help. The situation is aligning itself so that it's out of my hands. Usually, I'd be warring, warring, warring. I would KNOW what's best for this kid. The truth is I think I DO know what's best. But I can't make her choices for her. And if she continues on the path she's on, it will be out of my hands, and she'll be out of my life. Today, I'm more at peace with that possibility than I ever thought possible. I know today that I'll be ok no matter what. And when she's ready, the kid will be ok too. I may not be her particular instrument of change. But she's got a Higher Power too. And I can trust that she'll get what she needs, regardless of whether it's what she, or I, want.

HALT!

I essentially have 3 lives. A work life, a home life, and a recovery life. I haven't been to my work life in a week because of my kidney stone. I won't talk about the home life outside of the parts involving adults. But let me just say, there are major issues. A professional associated with my home life told me to turn off my phone. Essentially, she's telling me to HALT. It's good that my recovery life gives me tools that I can recognize and apply in my work life. I may not always choose to use the tools, but I know I have them.

Please see me, revisited

Here I go again with that feeling like I'm screaming out exactly what I need and I'm not being heard.

After calling the doc in hysterics this morning saying that I can't take another week of this pain, they agreed to fit me in today. I told them what meds I'd taken, and they said that it was ok, but that I'd have to stop taking the motrin immediately.

Today was a miseable day. The meds I'm on make me dehydrated, and I wasn't allowed to eat or drink all day.

At one point, I called my partner and begged her to bring me to the ER for the day until I could be seen. But the docs told me not to go, b/c they'd give me meds that would prevent me from having the procedure. So I stuck it out at home.

When I'm sick, what I need more than anything is petting. When I'm emotionally needy, my partner withdraws from me. Fun times. I felt like I was being really clear in telling her what I needed, but I just wasn't getting it. She needed her hand to smoke a cigarette while she was driving, so she couldn't touch me. I sat there trying to pet myself. It just doesn't have the same effect.

Once I'd gone through all my preop procedures including an IV and sedation meds, I was ON THE TABLE when they asked (for the third time today) when was the last time I'd taken a motrin. I answered the same thing I'd been saying, yesterday. They told me they couldn't do the procedure. AAAAAAAAAGGGGGGHHHHHH!!!

We got home, and my partner went downstairs. She went and did a few errands, coming back into the house 3 different times, but not coming upstairs to check on me. I know she's overwhelmed, but I really needed her. I thought about ways I could get my petting and food needs met without my partner. I called a friend who's a great nurturer for me, only to find that she's in the hospital too. And my wonderful recovery friend offered to drive across town to bring me some broth.

I guess my secret message was in humility. I had to really humble myself to my partner and lay out what I needed from her. I told her I need lots of extra petting right now and I need her to check on me more often. I think I got through. I hate that it's such an effort.

Kidney Stone

Apparently, I've been jealous of the collection of hospital bracelets everyone in my household has been getting in the last month, so last night I decided to get one of my own. During my Naranon meeting, I was having a weird pain in my lower back that was so intense at times that it was making me vomit. I ended up having a friend bring me to the hospital, where I was diagnosed with a 6 mm kidney stone. They say that that is really large, and it's unlikely that I'll be able to pass it on my own. To make things even more fun, I'm allergic to sulfa drugs, which means I can't take the medicine that would help my urinary tract. Sigh.

I'm proud of myself for speaking up and not suffering in silence, and for going straight to the hospital. (Of course, my original plan was to wait out the meeting and then go home if I was feeling ok.) But I did ask for and accept help.

I'm grateful that my partner is in a good place. She was really present and supportive. I'm a bit nervous about having narcotics in my house, but I'm trying to turn that over. As my sponsor says, if she ends up relapsing, I can trust that God has plans for more research for her.

Relationship Growth Spurt

We had a 3 hour session with her therapist on Friday, and my partner has been fully present since then. It was really hard and really good. She told me later that her intention in inviting me was to have her therapist fix me by telling me to go on an antidepressant. What happened instead was that the therapist really helped us explore core issues and to really hear each other.

We talked alot about her dissociation and how it affects each of us. She was really able to own how much she goes away. She even told me that when I cry, she dissociates. It makes sense to me that emotionally charged situations would be really hard for her and that she would protect herself by going inside of herself. It also makes sense to me (and finally to her, too!) that I don't feel seen because of it.

We talked about her unwillingness to use intentional dialogues. She said that they're really hard for her because she can't remember what I said and then it's hard when she has to give it back to me. We both got that this, too, has to do with her dissociation. When she goes inside herself, it must be incredibly hard for her to validate and empathise with my experience. It's also incredibly hard for me when I'm pouring out empathy and validation and getting little back. I end up feeling frustrated and unimportant and out of balance. She ends up feeling frustrated and worthless and hopeless. I think maybe my sender responsibility is to pay attention to when she goes away and stop talking until she can resource herself and come back. Another sender responsibility that I have is to try to speak my truth, but in a way that she can hear, either by giving less information at a time, by containing my emotions to the best of my ability(by resourcing myself) and sharing with her honestly, but in ways that she's more likely to hear. I want to say what her receiver responsibility is, but that would be taking her inventory. My therapist tells me that I've been overcompensating, though. It makes sense to me that when I feel like I'm working harder and harder and harder and not getting much back, I end up with big resentments that are NOT healthy for the relationship.

We also talked about her experience that I can't hear her no. She says that when she tells me no, I harass her until she gives in. She gave some examples, and I validated her experience. It's true that in each of the instances she shared, I suggested more and more alternatives until she agreed to one of them. I can see how she's feeling like she doesn't have a vote, because in each of the instances, we eventually did one of the things I suggested. Given all that, I imagine she feels trapped and powerless. I even get that boundaries are really new for her, and she needs to build fortresses right now in order to protect herself. It's just how I operate with my mother. It bothers me that the person that she's protecting herself from is me, but even that makes sense. It's that Imago thing we're learning about, where we recreate trauma experiences until we work through them. I am NOT any of the people in her life who traumatized her and did not respect her boundaries, but she's projecting that shit on me because she hasn't worked through it yet and I'm the person she's closest to today. I am understanding all of this stuff to the best of my ability without being her.

But I really need her to be able to see my side. It's really lonely to be a partner to someone who's busy building fortresses to keep me out. It triggers the hell out of my abandonment issues. Those issues weren't installed by her, any more than her victimization issues were installed by me. But her behavior affects me. As much as I can understand it, it doesn't mean that it doesn't hurt! What she sees as me not hearing no, I see as her not being able, yet, to enforce her own boundaries. That makes sense to me, too, because I have a hard time enforcing mine. I'm learning, through watching her struggle with this, that it's my job to enforce my boundaries and it's her job to enforce hers. It feels to me like she's blaming me for her failure to enforce her own boundaries. And, while she's busy building fortresses, she's not very negotiable. I see the same thing that she sees as me badgering her as her unwillingness to negotiate. Again, I get it. Boundaries and negotiation are new and hard for her. But it leaves me in a no-win place. She's not throwing out any alternatives. And then she's blaming me when I continue to come up with alternatives and then SHE finally agrees to one. Maybe this is my part here, and what I can try to do differently in negotiation. Again, I can slow down. I can pay attention to whether she's with me. I can ask her to come up with another alternative instead of continuing to put more and more options on the table.

Here's the good news. After our 3 hour therapy session, she's being fully present with me. She understood what I need in terms of validation and empathy, and she's really working on giving it to me. I'm not feeling abandoned right now, because she's not going away inside of herself right now. She's taking more risks and telling me her truth. As she's sharing her truth with me, I can be more compassionate and I can own my part and figure out what I need to change. We're being able to process things all the way through until we both feel heard and validated and we're being able to come to resolution together. For now, it feels like we're BOTH really working on the relationship. I don't feel so out of balance. And that feels really good.

Secret Message Decoder Ring

My step group is starting Step 11, where we pray for knowledge of God's will for us and the power to carry that out. I'm finding that I'm receiving a new gift of clarity. I've taken to calling it my secret message decoder ring. I'm asking for God's will for me, and I seem to be getting better at using my decoder ring to understand the answers.

I love the Promises from the AA Big Book, and I'm finding that with my new secret message decoder ring, this one's coming true:

-We will intuitively know how to handle situations that used to baffle us.

It's a really cool gift! And speaking of that cool gift, this is my 100'th post. According to my secret message decoder ring, God wants me to keep speaking my truth here. And to know that this gift is a bigun. Thanks, God!!!!

PLEASE SEE ME!!!!!!!!!!!

I had a huge blow-out tantrum last week. I felt like I'd been asking and asking and asking and asking to be seen, validated, and empathized with. But my partner was too absorbed in her own stuff, and she couldn't see me. Finally, last Wednesday, I had a complete melt-down where I was a sobbing mess, begging her to see me.

I get that her stuff really isn't about me. But it does affect me. And I was completely done being invisible.

The scary hard thing is how effective tantrumming is. I don't like it. It feels way out of control and scary. But I have to admit that it is the one thing that gets attention when I'm feeling invisible. I see why 2 year olds use it.

Tonight, I did some work in therapy around it. We identified some of my really old family of origin wounds that created this overwhelming need in me to be seen. My therapist told me about some work she'd done around the same issue where she took pictures of herself as a kid and really saw that little girl and nurtured her. She reminded me that the only person who can really abandon me today is me. She helped me to really see my own little person and to nurture her.

I came home and told my partner about the work I did. I told her that I was working through feelings around last Wednesday. Her response: "Refresh my memory." ARGH!!!

Adding God to my amends list

I recently completed step 8 with my online step group and am now starting 9. Meanwhile, a situation came up at work. I've been having difficulty with a person and a situation. It has been becoming more and more unmanageable for me, but I've been unwilling to deal with it directly. On Wednesday, the situation came to a head, and I ended up reacting out. I cried an ugly cry, as Oprah would call it, and poured out all of my feelings to one of my supervisors. She, in turn, wanted to bring it to the top boss. I told her that I was afraid, in part because the top boss is close friends with the person that I'm struggling with.

On my way to work the next morning, I prayed for the right words when it's time to talk to the top boss. I made an amend (in my head) saying that I was sorry for not trusting her when she had given me every reason to trust her. I rehearsed and rehearsed, trying to come up with just the right words.

Suddenly, it occured to me that this was another occasion where I was trying to control out of fear, and the solution to my fear is faith. I then realized that it's God that I owe that particular amend to- I haven't trusted God to give me what I need when I need it. So, I'm heading back to step 8 to add God to my amends list.

Heart Troubles

My partner spent the night in the hospital on the Chest Pain Unit Tuesday night. She started having this pain during therapy (surprise!) A few hours later, after successfully completing a CPR class, she told the instructor about her pain, and he recommended that she go to the hospital.

This is not the first time we've gone through this. Each time, they run her through a series of tests, and each time they clear her to go home. I thought I handled things pretty well during the time. I wasn't overly anxious and I didn't completely detach to the point of ignoring the symptoms which may have been life threatening, although they have never been before. Our therapist strongly encouraged her to call her doctor when she started having symptoms during our session. She refused, and I left it alone. When we completed the CPR class, I suggested that she tell her symptoms to the instructor. When he suggested we go to the ER, I took her. When she decided that she didn't like the smell of the first ER and wanted to go somewhere else, I did what she asked. (Even though by that point it had been more than 4 hours since she'd first started having symptoms. If it WAS a heart attack, she probably would have been dead by then.)

Afterwards, I asked for permission to give her feedback, and when she gave it to me, I suggested that she give her doctor and therapist permission to communicate with each other. I also suggested that she might want to ask her therapist to help her with some body work to maybe work through whatever it is that keeps bringing her back to this place. I even told her the next day how I was feeling- unappreciated and unimportant. She acknowledged that she hadn't thanked me for being there for her through the ordeal and that she did just expect me to do something for her rather than saying please. She said that she was being self-centered, but that if she ever were really dying, she wasn't going to say please and thank you.

The following day I was hovering on tears. I don't know if it was just exhaustion or if I had some unprocessed feelings left. I'm kind of beating myself up for being frustrated with the time and money involved in these hospital stays that never find anything. It's also scary though to think that there could ever come a time when I'd ignore the whole thing and it might actually BE a heart attack and I'd be responsible for her death. A friend in recovery reminded me that I came by these feelings rightly, and that my partner could actually call 911 if she ever really thought she was having a heart attack and I wasn't responding.

I sure wish she'd sort this stuff out though. I'm getting tired!

White Chip

My partner told me yesterday that she'd be picking up a white chip in the evening.

She told me that over the past couple of weeks she's been taking various medications, from a common over-the-counter cold medicine that has a lot of alcohol in it to some leftover muscle relaxants that belonged to someone who used to live in our house and some other things. She said that her therapist, who's a recovering alcoholic had told her weeks ago that she couldn't have the cold medicine, but she'd chosen to keep using it anyway and to use more than prescribed.

She has a new sponsor, who apparently told her that she didn't think that she needed to pick up a white chip. But my partner didn't feel comfortable with that, and kept asking others in recovery, and decided that she did need to pick up the chip.

I'm proud of her for putting it out there and for pursuing it when she was first given a pass by her sponsor. I'm glad that she's taking this stuff seriously and that it seems that for today, she's not sliding further down that slippery slope. I'm glad that she came to me and told me. I understand why I was the last to know, but that part is painful. The other part that's hard is the reality distortion. Just last weekend, we were at a recovery conference together and she was celebrating 6 months clean. Stupid me talked about how cool it is that they honor 18 months and that she'll be able to stand up for that next year. I was also starting to look forward to her finally having a year clean and being able to speak to my naranon group. What I now know is that she really didn't have 6 months when she was standing up dancing and cheering. I do struggle with that reality distortion thing. Oh well. I have tools. So does she. For today, she's taking her recovery seriously. I can't really ask for more than that.

Hung up on my mother

Hmmm. It's interesting that my title can be taken two ways, and while I meant it literally, the other way is also true. I AM hung up on my mother. She still has a lot of power over me. She's very invested in trying to control me and I'm just as invested in not letting her.

Today, she shared a very reasonable concern for my safety. The problem is that she has shared this concern before and had my sister in law share it too. Today she reminded me that she and my sister-in-law shared this concern and told me that she had found a newspaper article that she wants to send me about the concern. She told me all about the dire consequences that will happen if I don't take the action she wants me to take and that I have to take that action to protect all the members of my family.

Every time she took a breath, I told her "thank you for your input." She asked me why I was thanking her for her input and why I wasn't doing what she was telling me to do. I told her that I understand how frustrating it is when you want someone to do what you believe is good for them. (GOD, DO I UNDERSTAND!!!!) She told me that she wasn't frustrated, she was panicked. Actually, I totally get that too. Finally, I told her that I understood what she wants me to do, and if she continues to discuss it that I'd hang up. She continued. I told her I love her and hung up. Later, I called back and left her a message saying that I love her and that she is welcome to suggest that I do something but she is NOT welcome to insist.

You know, the truth is that she is absolutely right about what she's saying. And I really do get that controlling comes from fear. It was a good reminder of what I look like when I'm trying to get my partner to do things the way I want her to, and that the more controlling I am, the less likely that she, or anyone else, is going to do things the way I want them to, no matter how right I might be.

Thanks mom! That wasn't the lesson you intended for me, but it's the one I got. Just for today.

Plotting with Mr. Junky

I think my partner must be hanging out and plotting with JW's husband, Mr. Junky. Yesterday, she got all addicty when I confronted her about a particular behavior. She darted and weaved and I ended up apologizing all over myself for a behavior that I had owned and cleaned up when it happened weeks ago. Meanwhile, she was sulky and pouty and at the same time smirky over her current behavior that was clearly wrong. Then, she turned herself off and went to sleep.

You know, it amazes me that she can do that. For her, withdrawing to the bed and literally pulling the covers over her head is a coping mechanism that she's remarkably good at. Typically, her withdrawal to the bed activates my anxiety, and I have an even harder time going to sleep. So, when we're in a stuck place, she ends up oversleeping, and I end up undersleeping. Fun times.

I did pull out my maladaptive tool of projecting. I planned a miserable day for us for today with her being all withdrawn and me figuring out how to survive the day. I also predicted that she'd spend the day in bed and not follow through on a committment we'd made together for this day. I plotted how her poor choice was going to grow and impact our family all the way out to a grand finale that I'm particularly worrying about. More fun times.

But I also called a friend, who told me that my partner probably knows what she did wrong and reminded me that I can't make her feel more badly about herself than she already does. She suggested that I do nothing and do my best to enjoy this day. She said to use it as an experiment and see what happens.

And guess what? My partner must have consulted Mr. Junky again last night while she was sleeping. Because this morning, I got my own bread from the hardware store. My partner called me over to her, looked into my eyes, apologized for what she did, owned what she should have done differently, and then cuddled with me. All's right with the world.

Spiritual Fanny Pack

My sponsee shared this great reading today about trust. I'm pasting it below this post. I can't give credit, b/c I really don't know where it came from.

I have a new child who came into my life yesterday who came with a laundry list of diagnoses. One of the diagnoses is Reactive Attachment Disorder (RAD.) One of the common behaviors of RAD kids is hoarding, b/c they have been deprived and don't feel that they will be provided with enough food to eat. One of the interventions that's used sometimes is to give them a fanny pack of food that they can keep with them, and keep restocking it when it's empty.

When I read the reading below, I realized that I've been hoarding when it comes to control, and that what I need is a spiritual fanny pack. The truth is that I already have this spiritual fanny pack, and I carry it with me. It's always accessible if I reach for it, and it's always stocked.

My sponsor tells me all the time that I should pray to turn fear to faith, and I'm sssssllllllloooooooowwwwwwwwlllllly coming to understand just what that means. Just for today, I'm going to trust that I already have everything I need. There's no need to hoard control, b/c I have a never ending supply in my spiritual fanny pack.

Here's the reading. Enjoy!

"CONTROLLING VERSUS TRUST
There was a time in my life when I felt so afraid of and overwhelmed by the very act of living that I actually wanted to make out a schedule for each day of my life for the next five years. I wanted to include all the chores I had to do, when I would do them, even when I would schedule relaxation. I wanted to get some order into what felt overwhelming. I wanted to feel like I was in control.
Anonymous

Controlling is a direct response to our fear, panic, and sense of helplessness. It is a direct response to feeling overwhelmed, and to distrust.

We may not trust ourselves, our Higher Power, the Plan, the Universe, or the process of life. Instead of trusting, we revert to control.

We can approach this need to control by dealing with our fear. We deal with fear by trusting---ourselves, our Higher Power, the love and support of the Universe, the Plan, and this process we call life and recovery.

We can trust that when things don't work out the way we want, God has something better planned.

We can trust ourselves to get where we need to go, say what we need to say, do what we need to do, know what we need to know, be who we need to be, and become all we can become, when we are intended to do that, when we are ready, and when the time is right.

We can trust our Higher Power and the Universe to give us all the direction we need.

We can trust ourselves to listen, and respond, accordingly.

We can trust that all we need on this journey shall come to us. We will not get all we need for the entire journey today. We shall receive today's supplies today, and tomorrow's supplies tomorrow. We were never intended to carry supplies for the entire journey. The burden would be too heavy, and the way was intended to be light.

Trust in yourself. We do not have to plan, control, and schedule all things. The schedule and plan have been written. All we need to do is show up.

The way will become clear and the supplies will be amply and clearly provided, one day at a time.

Trust, my friend, in today.

Just for today, I will trust that I will receive all I need to get me through, today. I will trust that the same shall happen tomorrow."

It's Not About the Batteries

I'm on my 3rd day of struggling over a silly little squabble my partner and I had. It started when she was in the bathroom, and I came in and handed her some batteries and told her that they go in the charger. The next morning, when they were laying on the counter next to the charger, I got upset. She got angry with me and told me that I didn't ask her to put them in the charger. I agreed that I didn't ask, and told her I'd work on that. She said she didn't do anything wrong and left PISSED!

I tried to have an intentional dialogue with her later, and it went downhill fast. First, she delayed and delayed and delayed the dialogue, until she was in bed and had already taken "bedicine." When we finally had our dialogue, I really worked at owning my shit, and my perception is that she really worked at protecting herself. Needless to say, it didn't go well.

Today, I'm still struggling. It's really not the batteries I'm struggling with. It's the fact that my need to process through feelings together and come out on the other side together is colliding with her need to avoid conflict and to build her wall of self-protection when she thinks she's being attacked.

We have this same struggle often, when I want to process through something and she doesn't. She says I'm trying to control her, and in a way I have to own that I am. I want her behavior to be different, and I can't make that happen. Maybe I need to figure out a way to resolve my feelings without her, but that makes me sad. A friend in the fellowship reminded me that hadn't I just worked through a really, really, hard lesson in letting go? Did I really need God to provide more growth opportunities in that area? I was able to get clear that I need to let my partner know that I'm really struggling, not with the batteries, but with the dance we do when there's conflict between us. I need to speak my piece, and then I need to let go of the outcome. Or, God can certainly give me some more opportunities to practice that letting go thing.

Playing Tug Of War with God

I guess I've had some lessons to learn, and maybe, just maybe, I've finally learned them. God and I have been playing tug of war over a kid who's very important to me. I think I've let the situation go, and it comes back to me. And around and around we go, faster and faster. Each time the possibility returned that she might come back into my life, I got excited, and each time it didn't come through, I was crushed. My sponsor told me that at some point, I'm going to get to the point where I can say "whatever." Well, the final (at least it appears to be final) decision is in, and she's not coming back into my life. I can't say "whatever," but I'm not crushed. I hope things work out for her the way she wants them to, though I don't think it's likely. I really hope that she learns what she needs to learn from the situation and that she comes through it stronger. Today, I participated in a healing service during the Yom Kippur service. We sang the MiSheberah, and I put her name and the name of her mother out there. I wish healing for both of them. I wish healing for me.

Not My Will

I've had quite the roller coaster of a week. First, my partner and I had to make a decision. Once we came together, the kid in question, and the folks who are supposed to protect her, fell apart. The decision was put to me during Rosh Hashanah, and I really worked on giving it to God right from the start. I'm not sorry I opened up my heart again, though the outcome is clearly not what I wanted, at least for today. I've been riding the roller coaster of my feelings as the decision keeps being for sure one way and then for sure the other. Now we're back in limboland again. We've been asked to keep the option open for this child of my heart while she's thrown to the wolves. My sponsor once told me that if my partner decided to relapse that maybe she had some more research to do and that I needed to trust my higher power and hers. It appears that's where I am again, only it's this child that apparently has more research to do. God, please take care of her. God, please take care of me. Amen.

service work as an opportunity to work through character defects

I heard in an OA meeting not too long ago that service work was an opportunity to work through character defects. I didn't believe it, but it's true. I've recently taken on some service work in my online step study. One role I took on was homework monitor. We all made some shared agreements about how we would do homework on the steps. We agreed that if people didn't post for two consecutive weeks, they'd be put out, but that they could request the opportunity to come back if they agreed to do the work.

I was one of the people who agreed to share the role of monitoring. The first time I did it, I totally obsessed. I counted each response for each individual in the group. It wasn't too hard, because it was only the first week, so there was no worry that someone could actually reach the limit of being out. But I started getting anxious. What if they answered some questions, but not all? How do I word a reminder?

By my next turn, people actually being put out became a distinct possibility. I decided to add yet another reminder. This time, I'm serious, kinda thing. I told them that I'd be checking the next day, and gave the time. When a couple people didn't respond or post, I had a really hard time. So, here I was having the opportunity to practice setting and enforcing my boundaries. AFGO!!!

It was kinda reassuring this week, when someone else took on the task, and struggled with the same things. I wasn't alone. Shew.

Meanwhile, I discovered that I've been acting out more character defects in the group- people pleasing and controlling. In the beginning, a member of the group asked for help posting the questions. Of course, good codie that I am, I jumped in and did them. Then, week by week, I took on the task of finding someone to post the questions. This week, I just stopped and did nothing. Guess what? The world didn't fall apart. Someone commented that we forgot to find someone to post questions. My anxiety alarms ran, but I did nothing. Someone else picked it up.

Funny, this week, we're working on step 4, and look at all these character defects popping out of hiding. Guess I'd better go do my homework.

knowledge of God's will for me and the power to carry that out

The last few days, my partner and I have been struggling with a decision regarding a child who is very important to me and who has been a big challenge for her. The child was pivotal in our addiction story, and came close to causing the end of our relationship. She's also what brought us into therapy and resulted in huge positive changes in our relationship. Today, we have the opportunity for a do-over. My will is clearly that we take that opportunity. My partner has been all over the map with the decision. She's scared, which certainly makes sense. I've been trying really hard to turn it over to God.

Yesterday, the second day of Rosh Hashanah, was emotional for me in all kinds of ways. During the priestly blessing, parents who were with their children put their hands on their children's heads and blessed them. Those of us whose children weren't with us were told to send the blessing out to them. My parents were there giving me their blessing, and I was sending mine out to this child of my heart.

Later, during the last sounding of the Shofar, the leader of that part of the service suggested that we think about 3 things during the sounding. The first thing he said to think of was the sound of Sarah when she thought she had lost Isaac and to hear the sound of mourning. The second was that the shofar is a call to worship and a call to awaken spiritually. The third thing he suggested was that the shofar is to be sounded at the coming of the messiah, so to hear the shofar sounds as sounds of hope. So here I was, trying to turn this child over to God, and being told to hear the sound of a mother mourning her child, but also the awakening of the spirit, and the sound of hope. It kind of summarized where I've been these last few days- opening up this wound and opening myself up to the possibility of mourning yet again, but also connecting to God and to hope.

ELUL and the Steps

Last weekend, the student rabbi of my congregation gave me an ELUL journal. She had shared that we would have some opportunities to look at ways to journal in this month getting ready for the High Holidays. Since we didn't get to it as a group, she shared it with me. It was truly a gift.

I love how my religion, just like any religion or spiritual practice, matches so closely with the 12 steps.

Here's what I read about the four steps of Selichot, the quest for forgiveness:
1. Honestly admit the harm we have caused.
2. Make amends unless doing so causes further harm.
3. Ask forgiveness from those we have hurt.
4. Turn away from the hurtful behavior and do good.

For me, this fits exactly with my steps, though just not in the same order.
4. Made a searching and fearless moral inventory of ourselves.
9. Made direct amends to such people whenever possible, except when to do so would injure them or others.
10. Continued to take personal inventory, and when we were wrong, promptly admitted it.

Then, there's Teshuvah, returning to God and godliness. For me, this fits with these steps:
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God, as we understood him.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of his will for us, and the power to carry that out.

I am supposed to be almost finished with this journal, since Rosh Hashanah starts tomorrow night. But here I am again, doing it perfectly imperfectly. And now I have yet another tool for my toolbox. Thank God!

Step 2- OA Edition

We just finished step 2 in my online writing workshop. Yesterday, we read step 2 in the OA 12 and 12 in my OA meeting. The beginning of the reading focused on the insanity of the disease of compulsive overeating. There was so much that fit me. Eating way past being full to the point of being uncomfortable over and over again is the one that resonated the most. It really is compulsive behavior.

You know, one of the first things someone told me when I was trying to understand abstinence in OA was to choose one trigger food and abstain from that. For me, it was car candy. If I have candy in the car, I over-eat it. Last week, for the first time in a while, I bought a bag of candy corn and put it in my car. I decided a few days ago to limit myself to 5 pieces in every car trip. That worked for a few days. I thought to myself that maybe I'd figured out a plan of eating car candy. But then yesterday, ON MY WAY TO MY OA MEETING, I finished off the bag. Ok, God, I guess I really AM an addict, and I can't have car candy and eat just a little.

Later in the step 2 OA reading, they talked about the destructive cycle we go through. It talked about how we turn to food for comfort, but we need more and more. It said that we keep seeking that comfort that comes from food, even when it stops working. You could have inserted crack or opiods for food in that passage, and it would have been the same. I really DO have an addiction and I really am powerless over it. There really is insanity in my relationship with food. And I have come to believe that a power greater than myself can restore me to sanity. It works for my disease of codependency. It can work for my disease of compulsive overeating as well.

$5,000

My partner procrastinated on something, and it looks like it's going to cost her daughter $5,000. She'd been asked to send in her tax returns to the financial aid office. The school hasn't been really firm with the boundary. First they said that her daughter may not be able to register for fall classes. The boundary kept getting pushed. Today, her daughter called crying saying that the deadline was today at 5pm and it'll cost her $5,000. It's now done, and I don't know if it's too late. I also don't know how I feel about it. I don't want my stepdaughter to pay for my partner's mistake, particularly in her senior year. But I don't want to pay for it either.

I'm working on a balance between compassion and detachment. I'm trying to stay on my side of the street. I'm trying to stay in today. And I'm trying to trust that whatever happens as a result of this will be for my stepdaughter's, my partner's and my best.

God of my Growing Understanding

The first time I worked the steps, I believed in the power of the 12 step program and in the power of my group. That was enough for me to continue working the steps despite my status as an Agnostic Jew.

Then, the most recent time I worked the steps, I embraced the idea that I really didn't have to understand, and started praying to the God of my Lack of Understanding.

Now, here I am on Step 2 again, and I'm noticing that I'm much more comfortable with and in tune with a growing understanding of God.

This weekend, my Jewish community had a weekend study. We looked a lot at our undertanding of God. Our visiting student Rabbi talked about being made in God's image not being a physical thing, but rather that when we are doing right in the world, we bring a piece of God to the world. That works for me. She also shared some liturgy describing the relationship between God and people in many different ways and described it as many different entry points into a relationship with God.

I still don't buy the Disney Dad God or the Wrathful God. I don't know that there's someone up there watching every move I make and making decisions based on my behavior. I also don't buy God, the puppeteer, who's got me on a string and I only think I'm making my own decisions.

But God as the still small voice inside me that helps me choose the next right thing, that works for me. God as the message that really speaks to me from a reading or from a friend also works for me.

And regardless of my complete lack of understanding or my growing understanding, the program, and my understanding, works when I work it.

AFGO- Pain

I've been working on Step 1, and we had these questions about pain. Here's what I said Saturday when asked what areas of my life are causing me sadness:

"Right now, I'm not experiencing sadness. My disease tends to be one of extremes. Things at work and at home are going well at the moment, and I'm really not sure what to do with myself. When my addict's issues are bouncing up against mine and there's nothing I can do to "make" her do things differently, I have great sadness. I have learned, through much pain, that I really can't control her. So, when she's acting out in ways that affect me, my only choices are to live with it or to make changes that can feel extremely uncomfortable, and in those times of deciding what I'm going to do, I experience great sadness."

Then there was the question that said that pain is a signal to act out my addiction, obsession or compulsion and asked what pain is my loudest signal. I said:

"My loudest signal is perceived abandonment. When my partner withdraws to the bed or refuses to work through an issue with me, it triggers me to act out my own addiction, obsession, and compulsion."

So, what happens? My partner has physical pain, she withdraws from me, and I start acting out in my disease. AFGO!

Using my tools- perfectly imperfectly

Yesterday, I said:

"And guess what? It's the weekend. My addict is piddling around the house, mostly NOT engaging with me. She's also being very loud about her back hurting. I'm not sitting around the house waiting for her to spend time with me. I'm not obsessing about whether she's going to decide to self-medicate and relapse. I'm busy with my own life and my own program. For today, I'm working it, and it's working!!!"

Well for the morning anyway. By night time, I was anxiety ridden over my abandonment issues and triggered over her combination of back pain and isolation and I overate and did not get enough sleep. Sigh. Today's a new day!

My post was supposed to end here, but speaking of today being a new day, my partner just came home after leaving for work. She said she forgot her bra and now she's in a bind. She said she can't afford another occurance, and if she goes in late, she'll get one, but if she takes the day off and goes to the doctor, she won't. I told her calmly, that I can't afford to pay for another day off without pay and that she needs to have a plan for when she runs out of days. She said that she'd have to come up with a plan when that happens. I told her that I need a plan NOW. She said she guesses she'll just go in sick. I asked what would happen if she doesn't. She thought for a bit, and then said that she'd make it up out of her spending money. I said that's fine, or you can do overtime, or whatever else you need to do, but I can't afford to pay for another day of lost wages. I said that this is a very clear boundary in my head, and you need to know it. I said what I meant. I meant what I said. And I said it firmly, but not mean.

One step back, but two steps forward. NOW, on with the day.

Using my tools

Today, I did some step 1 work. I did what I committed to myself and the internet that I was gonna do, and addressed my compulsive overeating while working the step. Afterwards, I decided to make some program calls to members of OA. That's getting out of my comfort zone. I'm finally to the point where I'm totally comfortable picking up the phone and calling my naranon friends.

But today, I reached out in particular to someone that I really don't know, but who seems to have what I want. I asked her about her experience working the steps in OA. She told me about her experiences. She pointed me to a 4th step tool that's specific to OA. She told me about a 12 step guide that she used, and agreed to email me with information about the guide. She talked to me about some of her successes and some of her struggles. She talked about getting ahead of herself when on step 4 by thinking about the upcoming work she would have in making amends. She mentioned that she's in more than one recovery program (just like me) and that she wanted to do one inventory, but that that didn't work for her. She found that she needed to address her separate issues separately. She talked to me about things that were getting in the way of her 9th step work, and how she's handling them. I'm so glad I made this call. I hung up feeling very uplifted.

I guess when I think about it, I also did some 12 step work today- carrying the message to those who still suffer. I helped a friend who's got a whole lot of recovery behind her but is very new to step work. And I reached out to somebody online who's where I've been, and shared my experience, strength and hope.

And guess what? It's the weekend. My addict is piddling around the house, mostly NOT engaging with me. She's also being very loud about her back hurting. I'm not sitting around the house waiting for her to spend time with me. I'm not obsessing about whether she's going to decide to self-medicate and relapse. I'm busy with my own life and my own program. For today, I'm working it, and it's working!!!

Stepping it Up again

I went to a new (for me) OA meeting this morning. I have this love/hate relationship with OA. It's taken me forever to identify myself as a compulsive overeater in those rooms. The format of this meeting is 12 and 12. They read and discuss the steps and traditions, rotating back and forth. Apparently, last week they finished tradition 12, so today, we started with Step 1.

Meanwhile, I've started another step study group online, and where are we this week? You guessed it, Step 1.

I'm getting pretty comfortable with my naranon issues, and getting much better at being able to look at myself when I'm working the steps of Naranon. But I've found that when I'm in OA meetings, I tend to focus on the Naranon/Codependency issues rather than my compulsive overeating, even to the point of being unwilling to self identify as a compulsive overeater.

So I made a committment in my OA meeting, and I'm putting it out here to, in order to hold myself accountable. This week, when I'm doing my writing about Step 1, I am going to be intentional about including my compulsive overeating. So, everybody, I'm R, I'm Codependent, I'm a Lesbian, AND I'm a compulsive overeater.

Live and Let Live

Yesterday's reading in the Naranon daily reader, Sharing Experience Strength and Hope, talked about the slogan, "Live and Let Live." The writer said that s/he worked it backwards. S/he first learned to let live, and then learned to live.

I realized that that slogan worked for me yesterday as soon as I chose to work it. But for me, I had to live in order to let live. I chose to spend about an hour being home alone and miserable after my expected losses. And I waited, ever so patiently, for my designated babysitter to wake up and come play with me. You know, even while I was doing it, I could see how that waiting shit so doesn't work for me. And how I was playing out the exact same psychodrama I play so well and so often with my addict without the addict in the equation. It wasn't the giving my friend space to sleep in that was a problem, any more than giving my addict that same space. It was the fact that what I was choosing to do with my time was wait for somebody else. So after an hour or so of that, I made a different choice. I went out and played with a baby. It was just what I needed to jumpstart my day.

I went out and played with my designated babysitter. She indulged me in my fantasies of creating natural consequences for my addict. Of course, the fact that I'd be creating them makes the consequences decidedly unnatural. But my wise friend didn't point that out to me. We went to a meeting, where among other things, I heard today's reading on the slogan, live and let live. I then spent a wonderful 3 hours with another friend in recovery. We sat outside listening to live music and sharing.

On my way home, I was listening to the radio and came up with the silly but fun idea of throwing myself a dance party. So that's exactly what I did. I now have a fun artist's date to report back to my Artist's Way group. And I honestly had fun alone in my house. Whoda thunk.

The not so surprising thing is that the more I live my own life, the easier it's becoming to let live. I don't need to call my addict on her addicty ways. And I don't need to create natural consequences for her. I'm too busy living.

Abandonment AFGO

I'm apparently supposed to be looking at my abandonment issues today.

My partner went away on a planned recovery retreat for the weekend. Then, Thursday, we found out that we'd be facing another major loss today. The other loss was not unexpected, but it doesn't make it any less hard. And because of her retreat, I'm having to face the work of it and the feelings of it alone. Rah.

Her leaving was unpleasant. I know she was excited, but she was also incredibly self-absorbed. I was trying to deal with my feelings surrounding her short leave and then today's permanent one. I was trying not to be clingy. She made it easier and easier not to be clingy with her obnoxiousness towards me and everyone else in the house. Before she left, I'd finally had enough, and told her so. I told her to have a nice trip, and went back into the house. As she left, she apologized for being bitchy.

Now I'm caught in that damned trap between detachment and accepting unacceptable behavior. I want her to know exactly how she added to my pain this weekend instead of sharing it. I want to spell it out for her, give her a laundry list of her transgressions.

I'm also realizing that I'm wanting to use my hurt and anger about her behavior yesterday to distract me from my feelings of today.

I'll survive this loss. I always do. And I've chosen this life situation which involves attaching and then losing people in my life. What makes me so good at what I do is the very thing that makes it so hard when it's over. This time, I knew going in that it was particularly short-term. The first time I went through this, I thought I was gonna die. But I didn't. And I didn't REALLY lose the person. He's just in my life in a very different way today. Today's loss makes number 8 and 9. I'll survive it, like I have every other one. And I'll willingly sign on for more.

I've made some tentative plans to take care of me this weekend. I'll get through it. I wish we were getting through it together, but that's just not in the cards today. God apparently REALLY wants me to work on this abandonment stuff today.

Julia Cameron keeps talking about me

I'm on the second book in the Artist's Way series. Last week, in week 9, Julia talked about the difference between worry and fear. She says that worry is obsessive and flits from subject to subject, seeking out worst case scenerios. Worry's job is to distract us from what we're really afraid of, according to Cameron. She also says that while most of us are afraid of fear, it's actually a good grounding thing, telling us to do something to take care of ourselves.

Last week, while I was supposed to be reading this chapter, I was busy worrying- worrying that my partner was abusing my kid's narcotic pain meds, worrying that she didn't want to spend any time with me, and creating all kinds of miserable scenerios about going back to work next week. I was a mess. That wonderful friend I was just thanking said to me at one point, "What's wrong with you? You're doing everything wrong!" And she was right. Things were actually going pretty well in my life, but I was using worry to create all kinds of crazies for me all over the place.

This week, Julia's talking about me again. "Nervous, we create dramas to make ourselves more nervous. We announce, "I've been thinking about your character, and I'm not so sure I should trust it. What do you think about that, wife?" " Geesh, was she there in my house when I was codiexploding?

Julia has answers for me, when I choose to listen. This week, she's telling me to keep the drama on the stage, or for me, on the page. She says that when I'm not creating art, I am likely to create unecessary drama in my life. She's also telling me to catch myself a catcher's mitt- a somebody who encourages me, helps me focus, and when necessary, catches my pop flies. I have great catcher's mits in my life. But lately, I'm more likely to call them AFTER the balls are all lost in the field. So for today, I'm committing to writing here and to calling my catcher's mit BEFORE I throw my next ball. I'll let you know how that works out for me.

Thanks, Friend!

You might have heard that I've been codiexploding all over the place, lately. Well, a dear friend in recovery heard, and has been chasing me down to hear all about it.

She let me spew all of the minute details of my codiexplosions. She listened gently and without judgement, and reminded me to be gentle with myself. She pointed out things I couldn't see. She gave me the two gifts that have become the most important in the world to me- validation and empathy.

Thanks, friend!!!!!

Codiexplosions

I've been codiexploding all over the place in the past few days.

Saturday, my kid had surgery, which led me to a series of people pleasing behaviors that backfired and ended up hurting all involved. In the meantime, I didn't fill his prescription, hoping that he wouldn't need it and I wouldn't have to deal with narcotics in the house. He did well all day, but by evening, he was hurting. I went out and filled the scrip, but he had unneccessary time in pain because of MY fear. And I spent the night feeling guilty, both for the consequences of my people pleasing and for the kid's extra time hurting.

Last night at dinner, my kid and my partner were acting strange, and I jokingly (sorta) asked her if she'd gotten into the kid's stash. Then, a few hours later, I miscounted the pills and was sure that she had. I figured it out, but was left with all these feelings. Then, when I told my partner about them, she wasn't as compassionate as I wanted her to be about MY disease rearing its ugly head. Duh! I'd just told her I'd been accusing her in my head of something she didn't do. And meanwhile, I'm sure the narcotics in the house are doing a number on HER addict. She turned her entire body away from me and I dissolved into tears in an abandonment codiexplosion.

This afternoon, she agreed to let a friend of one of the kids come over for dinner and said she'd make ribs. Then, she promptly fell asleep and couldn't be aroused for hours. (For those of you loyal readers, her sleeping for extended periods is a major trigger for me.) We've been playing tug-of-war with the dinner bucket of shit. As far as I know, she's finally ordered pizza.

I think Mantra's Pissy Pants has invaded my house.

Go See Swing Vote!

And tell me what you think. I got free tickets to an advanced screening. It's not touted at all as an addiction story, but it certainly is one. The codie daughter broke my heart. It had its holes, but through my new lenses, I was clearly able to see the addict as separate from the man. I won't say more, b/c I know you haven't gotten a chance to see it yet. But once it's been out for a minute or so, I'd love to see some reviews. (MPJ AND TDA, this particularly means YOU!!)

Lose/Lose- Our current negotiation system

I get this clutch feeling in my chest when we're negotiating, regardless of what it is that we're negotiating about. I keep bumping into it lately. Saturday, it was negotiating for time. Sunday, it was over the last two pieces of pizza. Yesterday it was about whose turn it was to do the dishes.

We really don't negotiate well, at least not yet. It's not pretty. It's also not adult. We're two little desperate survivor children, and whatever we're arguing about takes on waaay more importance than who gets the pizza or who does the dishes. It's about survival, not just survival of the relationship, but of each of our very selves.

Our arguments must look really weird to an outside observer. This is how it looks to me like they usually go, with credit to MPJ for the codiespeak and to A for the courage to tell me what she hears when we're in conflict.

Me: I want to talk about how this (time, pizza, dishes, life) situation is not working for me. (Uh oh. Am I stepping on a landmine this time? Here goes nothing.)
Her: OK, let's talk. (Warning Will Robinson. I'm about to be under attack. OK, just hang on till it's over.)
Me: Here's what I think, feel, want. (What she hears: "blah, blah, blah, attack, attack, attack.")
Her: OK, have it your way. (Things aren't going to go my way anyway. If I give her what she wants, maybe she'll stop attacking me. Besides, this is all I deserve anyway. I'm worthless.)
Me: No, wait, have it your way. (Please love me. I'll try harder. I'll do better!)
Repeat last two lines until someone gives up.
Me: Are we OK? What do you need for us to be ok? (Oh My God! She's LEAVING ME! Come Back! I'll do anything. Just come baaaaaaaaaccccckkkkkk!!!!!!)
Her: I'm tired. I'm going to sleep now. (I gave her what she wanted. Why won't she stop attacking me. What I hear: "I'm going away forever.")

Needless to say, this cycle is not working for either of us. But I'm having a hard time breaking it. I'm getting better at the first part. I'm learning to put my wants and needs on the table in spite of my fear of abandonment. I'm also getting better at the second part- identifying what I feel, what I need, and what I want.

But it's all downhill for me as soon as I hear "have it your way." I'm all wrapped up in her head and I lose me. You know, even when I'm writing out this dialogue, I'm in her head, and that's dangerous territory for me. I guess I need to get better at taking care of me, and leave the taking care of her where it belongs, with her.

The truth is that neither of us is going anywhere, even though it feels like it to me every time we start down this path. Hopefully, as I get clearer and more focused on me, she'll get clearer and more focused on her. But whether she does or doesn't is her journey. And I really gotta get back to my side of the street.

Ever So Patiently

So, this morning, I was waiting ever so patiently for my partner to wake up so that we could go attend a very special event that we look forward to all year. This year, I'm doing something special there, that I'm excited and nervous about, and since I want to make sure I do it right, I wanna get there early and see other people do it first.

So, she's asleep, and I'm waiting, ever so patiently.

I try distracting myself by luring my sponsor to chat with me in our new toy. And I wait for her. Ever so patiently. Of course, ever so patiently involves stalking her, and bugging her and leaving secret messages for her everywhere, letting her know how ever so patiently I'm waiting.

Then, of course, there's a bug in our new toy, which gives me more and more opportunities to practice patience. There's no refresh button. God does have a sense of humor, doesn't he?

My partner finally wakes up, with just a teensy bit of encouragement from me. She gets a text message, and I lay her phone right next to her hand. Of course I let her know that I've been waiting, ever so patiently.

She decides that she has a particular shirt she wants to wear to the event, but it's dirty. She'll have to wash it. ARGH!!! I remind her about how patient I've been. I ask if she could at least wash it in the sink and then dry it so it can be done faster. We get into a silly argument over how long it takes to run a mini load in the washer. She tells me not to worry my pretty little head about it, and then tells me to quit whining. I get all tight inside, and then stop and tell her that it's ok for me to express my wants and needs and ask if we can negotiate. Negotiation is a tool we've been learning that we're not very good at, yet. We did it. Not perfectly, but we did it. And now I have more time than I wanted, but less time than I would have without negotiating. To wait. Ever so patiently.

keeping what i have by giving it away

Somebody was talking about her struggle around money in the Junky's Wives Club today. In sharing my own experience, strength and hope, I was able to get clearer for me. Here's what I said:

"What I'm learning is that I have to work on acting, and not reacting. I need to look inside myself to figure out what I want, what I need, and what I feel. That's been the hardest part, b/c I completely lost me for a while, and I'm just now figuring that out. Once I know what I need, then I have to set boundaries to take care of myself. You might, after looking inside, decide that what you need to feel safe is to have control of the money for now. Many addicts and addicts wives have come to that decision together. If you decide that you need to be in control of the money in order to feel safe, and you set that as a boundary, then it's up to him to decide whether he can live with that boundary or not. If he chooses not to honor your boundary, then it's up to you to decide whether you can live with that or not. It's hard, hard, hard, complicated stuff. I surely don't do it perfectly. But I'm getting better. Hang in there. And keep sharing. That's what's helped me the most."


Then later, I was just talking to a dear friend who's struggling with boundaries. She called me white light, and said she thought I didn't need my step group because I AM white light. I told her that MY disease is that it's waaay easy for me to boss other folks around, but it's much harder to let them in and see me and my struggles.

In talking to this friend, I got even clearer about the losing me I referred to earlier. I think my greatest character defect of all time is fear of abandonment, and it draws me to go to any length if I let it. I won't even state a boundary, let alone decide for myself what the consequence of invading it might be or, God forbid, follow through on that consequence, because the end result might be abandonment. And abandonment feels intolerable for me.

But, as I'm learning to date myself (go on artist dates and write morning pages and get more comfortable with me), I'm increasing my tolerance. And that's making me, and my relationships, so much healthier.

I'm so grateful for the tools I'm learning and my friends, real and imaginary, who help me to get clearer and healthier, one day at a time.

White Light

We finally met about the 12th step yesterday in our Step Group. It's been an amazingly powerfully healing journey. I look at the growth in the 4 women around me and I know I'm growing too. Getting ready to meet, I rediscovered a tool just when I needed it. I've been spinning for days and not realizing why. I'm finding that my feelings are a barometer for how my partner is doing. She's been working through something major and hadn't been ready to share it with me. My codie powers picked up that something was wrong, but the powers are a bit warped, so how it gets interpreted in my brain is that something must be wrong with me. Anyway, once I used this 12 step tool, I was able to get myself much better centered. And then, not so coincidentally, as soon as I felt more centered, my partner felt able to share what's been going on inside her. Wow! Yet again, it works when I work it.

Here's the tool, modified from from The 12 Steps- A Way Out.

Write a clear concise statement about a situation or condition that's really bothering you and bringing up big feelings (resentment, fear, sadness, or anger.) Then apply the principles of all 12 steps to work through the situation.

Step 1: Write about how this situation is demonstrating your powerlessness and your life's unmanageability.

Step 2: Ask yourself how your higher power can restore you to sanity. My response was that my higher power could help me focus on me.

Step 3: Write an affirmation about how you're now choosing to turn the situation over to your higher power. (Mine was "I now decide to turn my frustration and anxiety over to God.")

Step 4: Write down what character defects are surfacing. For me, it was control and fear of abandonment.

Step 5: Admit your wrongs to God, to yourself, and to another person. I used the exercize the book taught us in Step 5. First, I looked in the mirror and said it out loud to me. Then, I virtually, put God in a chair and said it out loud to God. Then, I told my partner.

Step 6: Write about your willingness or lack thereof to have God remove the character defects that have surfaced. I wrote that I am willing because I do want to stop spinning in response to her feelings and actions.

Step 7: Write a prayer humbly asking God to remove the shortcomings you just identified. Here's mine: God, please help me to keep the focus on me and to take care of myself. Help me to give A time and space to work through her own stuff.

Step 8: Make a list of those you've harmed. Mine was me and A.

Step 9: Describe how you intend to make the amend. What I wrote was that I needed to tell her that I've been getting all enmeshed again. When I told her and showed her my work, she said that she thought that I was supposed to actually amend something. Hmm. Guess I'm working on that living amends thing of changing my behavior.

Step 10: Look back over your work and see if anything else surfaces.

Step 11: Pray or meditate and then write about your higher power's will for you in this situation. I wrote that God wants me to have peace.

Step 12: Write about whether you sensed a spiritual awakening and your understanding of who's in charge, you or God. The book suggests that good indicators of who you see in charge are your attitude and emotions. I wrote that I did sense a spiritual awakening and that God is in charge, because I'm calmer and more focused on me.

This was such a powerful exercize for me. I want to make a little card to carry around with the book's version of this exercize. I'd like to try to remember to practice these principles in all my affairs. This, for me, was a very concrete way of doing that.

Hi, I'm R, and I'm a Lesbian

I talked about this in therapy yesterday, and then dreamed about it, so I guess it's still a big issue for me.

Last week, we went on vacation with my family. My dad and I went for a walk, and he asked me if I thought that the couples in our family were happy. When I didn't jump in with a yes, he said it wasn't a trick question. He said that he thinks he and my mom, my sister and her husband, and my brother and his wife are pretty happy and that A and I are too. But he said that the rest of them are not as physically demonstrative in public as we are, and he wondered if we were trying to prove a point.

I told him that we didn't realize it had been an issue for him in years, so no, we weren't trying to prove a point. I told him that we are very physically affectionate, but not in a sexual way.

I pointed out that while we were having this conversation, my dad had his arm draped around me, and I wondered aloud if that felt like an uncomfortable display of public affection. My dad sheepishly replied that he somehow felt that the particular moment felt more private to him, which was interesting, since we were on a very public beach boardwalk with LOTS of tourists meandering about.

I challenged him to consider that what felt different about him draping his arm around my shoulders was that he and I are not two females, and that it's his prejudice that raises his antennae when A and I hold hands or cuddle. I then pointed out all the couples around us that were holding hands or touching in some other way, and challenged him to look again in our family to see if my siblings or even my parents touch more than he realizes and he just doesn't notice. He agreed to look at it, and I did NOT agree to stop being affectionate with A around him.

The conversation left me with mixed feelings, and I keep coming back to them. I'm glad that I did not cowtow to his prejudice. I'm glad that he really seemed to hear me. It makes me sad that I still have to fight this battle, in society and in my own family. Next week is Pride in my community. I'm looking forward to holding hands with my partner and not standing out. I'll continue to do so in the presence of my family of origin, and maybe someday we won't stand out there either. So, dad, no, last week I wasn't trying to prove a point, but the next time we're together in your presence, I will be. And I still love you.

Codies AND Addicts: our meeting of 2

We've been travelling together. Night before last we tried to find meetings and got lost. So, like we did once before, we decided to have our own meeting, this time on the beach. It was really an awesome experience. Somehow, the formality of doing readings, choosing a topic, and not cross talking is really magical for us. Since it's been on my mind a lot lately, I chose the topic of what codies and addicts have in common. I started out sharing some of the stuff I talked about here, but as we went back and forth taking turns, we came up with a lot more. She shared that she thinks that both often come from backgrounds where we didn't get our needs met, though it may be less obvious in a codie's background. We talked about the vulnerability we both share. We talked about the fact that we both have to work the same steps and work through our own character defects. We talked about how for both, it's easier to look at the other person's character defects than to focus on our own. We talked about why the cycle seems to start out for each of us chasing and getting a high from our own behavior but why it ends up going south. She shared that the addict pulls in more and more as he or she is chasing that high, and that the codie chases the addict (our drug of choice). It makes sense to me. It used to work that I'd get all my needs of feeling important and belonging by taking care of her and her wanting to be taken care of. Then, as she isolated more and more with her drugs, I kept trying to pursue to get those good feeling while she was busy trying to withdraw. I wish I hadn't waited two days to post this, b/c there was a lot more that I'm not remembering now. But it was a GREAT meeting! And I'm really grateful.

Acceptance

MPJ and Indistinct have been blogging about acceptance. I do that "accept, damn you accept" thing that MPJ talks about too. I guess that's what Indistinct would refer to as compliance. But here's what I've learned in my magical meetings about acceptance. Acceptance doesn't mean that I like something or even that I agree with it. It just means that I recognize it for what it is and that I recognize that I can't change it, whatever the it that I happen to be struggling with at the time. Once I acknowledge that something is not to my liking but it is what it is and I can't change it,then I free up a lot of energy that I've been wasting in obsessing and/or manipulating. I have energy left now to figure out what I can change- my reaction, a boundary I need to set or a way to refocus my energy.

Codies vs. Addicts

I've joined a new community, The Junky's Wives Club. There seems to be a thread within a thread in "How do you get better" that I'm really drawn to. I'm obsessing (of course) about the label b/c it looks like an antagonistic us vs. them when I mean it in the compare/contrast kind of way. I mentioned in the other thread that I see my primary addiction as to my addict. And that just like my addict does, I start out engaging in the behavior of my drug of choice (being enmeshed) because it makes me feel good. But then, it takes more and more to give me the high until I no longer get the high, I just have to engage in the behavior.

For me, the flip side is way more complicated. I've been noticing over the last week that the addicts in my community tend to open and close with the "we version" of the serenity prayer- God grant US the serenity... In our naranon circle, we use what the addicts refer to as the "me" version. I do think that both versions are appropriate for the groups that are using them. I think that part of getting healthy for me is learning to focus more on me, figuring out who I am and what I want. I use my addictive behavior to avoid me. My partner tends to isolate in her disease. When she's in her disease, she'd much rather be alone with her pill bottle than interacting with anyone, including me. She gets extremely self absorbed and she can't even see me.

On the surface, it seems that she get's self absorbed in her disease and I get selfless. I've often said that we got waaaay out of balance, and for us to get better, I need to focus more on me and SHE needs to focus more on me. But here's where it gets complicated. My selfless behavior really is SELF LESS. It's not generous and loving. It's disappearing. The more I think about it, our behavior here isn't that different at all. Both of us lose ourselves in our drugs of choice. And as we get healthier, both of us become more available, both to ourselves and each other.

Today's morning pages

Part of my Artist Way class involves writing morning pages- 3 pages of free writing in the mornings. I'm supposed to hand write it, and being the rule-bound person I can be, I'm sticking to that, at least for now. It's been meaning that I've put less energy into writing here. But today, I think I'll copy what I wrote. It's a lesson I keep learning and relearning. For this moment, I think I've got it. Maybe if I put it here, I can at least reference it. Anyway, here are today's morning pages:

Here's my discovery of the moment. I AM being controlling, even though it's not my intention.

I wanted A to not go to Dr. P. It makes sense to me that I would have big feelings about this. And I'm relieved that she made the decision that she did. But it ain't up to me. What is up to me is what I do to take care of myself. My actions are my choice. Like, I could choose to turn him in to the medical board. Or I could choose to detach myself completely from her medical stuff. Or I could chose to end the relationship if it's just too painful for me. I do have choices, and sometimes they're really yucky choices. But what she decides to do is really not my choice.

So, it's the same with not going to work. It's just not my choice whether she goes to work or not.

My feelings are valid and real. I get triggered when she doesn't go to work. It makes sense to me that I'd get triggered. It's a loss of income for me. It also reminds me of really yucky times and it's often a precurser to more yucks. There's also usually much more to the story- omission- which is another trigger for me, b/c it makes it hard to trust.

I am completely powerless over her choices about whether to go to work or not. I've been trying to control this choice, and it's just not mine. I can't get her up and get her to work and keep her there all day. I can't get inside her body and determine what's really going on.

But I do have choices. I can go on with my life and find ways to fill it. I can separate finances if the money thing becomes too intolerable for me. And again, if she continues to make choices that are too damaging for me, I could choose to end the relationship. I can release her with love and hope that she and her higher power get things under control before they become too much for me. I can put the focus back on me. How am I feeling? What do I need to do to take really good care of myself? What I don't need to do is keep trying to manipulate her into changing. It just doesn't work. It's time to stop trying to fix her and start trying to take care of me.

Here we go again

My partner brought up the idea again of going back to our former doctor last night. She's actually being very reasonable and accomodating about it and I'm being certifiably crazy. She said that she's ultimately responsible for her medical decisions and that it's her responsiblity to check out what's being prescribed to make sure it's safe for her. She said that she'd like to go together to see the former doc, and that she'd sign a new release allowing me total access to the doctor. IF I didn't trust her, she said I'd have full permission to check things out with him directly. She said that we'd make an agreement up front that she is not to be prescribed narcotics unless it's a last resort. She said that what happened was her fault, since she lied to the doctor and that we didn't give him a fair chance. She said that she really trusts him and that he's a much better doctor than the one we've been going to lately.

Almost all of what she's saying makes sense logically, but I just get completely crazy over the idea of either of us going back to this man. I feel sooooo betrayed by him. Just the idea of him is traumatizing to me at this point. I don't really get why my feelings are sooooooo big around this, but they clearly are.

Yet again, I'm having this huge war within myself. On the one hand,I feel really hurt that she keeps bringing this option up. Every time I get completely triggered and end up a total mess and she tells me she gets it and promises not to go back to him and not to bring it up again, but then she brings it up again and I completely lose it again. At this point, it feels like she keeps retraumatizing me. But then again, I don't want her to keep what she's thinking and feeling from me.

I don't know. It's late. I'm a mess.

Angry

I'm finding myself angrier and angrier at the doctor who prescribed my partner's latest relapse. My partner holds some resposibility. She took the pills, she didn't double check about whether they were narcotics, she took more than prescribed, and she lied about it. But, on the other hand, my program says that the addict has lost all power of choice once they've taken the first drink, pill, or fix. It makes sense that she didn't take them as prescribed and that she lied about it. And she really did try NOT to put herself in that situation in the first place.

Here's what I've read about Tramadol (not Topomax, as I wrongly said first.)It specifically says not to give it to addicts or people at risk for suicide. Says that overdose can cause death within an hour and that there are withdrawal symptoms. DAMN. DAMN. DAMN!!!!!


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Ultram ER
Warnings & Precautions
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WARNINGS
Seizure Risk
Seizures have been reported in patients receiving tramadol within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of tramadol above the recommended range. Concomitant use of tramadol increases the seizure risk in patients taking:

Selective serotonin re-uptake inhibitors (SSRI antidepressants or anorectics),
Tricyclic antidepressants (TCAs), and other tricyclic compounds (e.g., cyclobenzaprine, promethazine, etc.), or
Other opioids.
Administration of tramadol may enhance the seizure risk in patients taking:

MAO inhibitors (see also WARNINGS - Use with MAO Inhibitors),
Neuroleptics, or
Other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections). In tramadol overdose, naloxone administration may increase the risk of seizure.

Suicide Risk
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
Prescribe ULTRAM ER with caution for patients taking tranquilizers or antidepressant drugs and patients who use alcohol in excess.
Tell your patients not to exceed the recommended dose and to limit their intake of alcohol.
Tramadol products in excessive doses, either alone or in combination with other CNS depressants, including alcohol, are a major cause of drug-related deaths. Fatalities within the first hour of overdosage are not uncommon. Tramadol should not be taken in doses higher than those recommended by the physician. The judicious prescribing of tramadol is essential to the safe use of this drug. With patients who are depressed or suicidal, consideration should be given to the use of non-narcotic analgesics. Patients should be cautioned about the concomitant use of tramadol products and alcohol because of potentially serious CNS-additive effects of these agents. Because of its added depressant effects, tramadol should be prescribed with caution for those patients whose medical condition requires the concomitant administration of sedatives, tranquilizers, muscle relaxants, antidepressants, or other CNS-depressant drugs. Patients should be advised of the additive depressant effects of these combinations.

Many of the tramadol-related deaths have occurred in patients with previous histories of emotional disturbances or suicidal ideation or attempts as well as histories of misuse of tranquilizers, alcohol, and other CNS-active drugs. Some deaths have occurred as a consequence of the accidental ingestion of excessive quantities of tramadol alone or in combination with other drugs. Patients taking tramadol should be warned not to exceed the dose recommended by their physician.

Anaphylactoid Reactions
Serious and rarely fatal anaphylactoid reactions have been reported in patients receiving therapy with tramadol. When these events do occur it is often following the first dose. Other reported allergic reactions include pruritus, hives, bronchospasm, angioedema, toxic epidermal necrolysis and Stevens-Johnson syndrome. Patients with a history of anaphylactoid reactions to codeine and other opioids may be at increased risk and therefore should not receive ULTRAM ER (see CONTRAINDICATIONS).

Respiratory Depression
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients alternative non-opioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures (see WARNINGS Seizure Risk and OVERDOSE).

Interaction With Central Nervous System (CNS) Depressants
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.

Increased Intracranial Pressure or Head Trauma
ULTRAM ER should be used with caution in patients with increased intracranial pressure or head injury. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure, and may be markedly exaggerated in these patients. Additionally, pupillary changes (miosis) from tramadol may obscure the existence, extent, or course of intracranial pathology. Clinicians should also maintain a high index of suspicion for adverse drug reaction when evaluating altered mental status in these patients if they are receiving ULTRAM ER. (See WARNINGS - Respiratory Depression.)

Use in Ambulatory Patients
ULTRAM ER may impair the mental and or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. The patient using this drug should be cautioned accordingly.

Use With MAO Inhibitors and Serotonin Re-uptake Inhibitors
Use ULTRAM ER with great caution in patients taking monoamine oxidase inhibitors. Animal studies have shown increased deaths with combined administration. Concomitant use of ULTRAM ER with MAO inhibitors or SSRIs increases the risk of adverse events, including seizure and serotonin syndrome.

Withdrawal
Withdrawal symptoms may occur if ULTRAM ER is discontinued abruptly. These symptoms may include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely hallucinations. Clinical experience suggests that withdrawal symptoms may be reduced by tapering ULTRAM ER.

Misuse, Abuse and Diversion of Opioids
Tramadol is an opioid agonist of the morphine-type. Such drugs are sought by drug abusers and people with addiction disorders and are subject to criminal diversion.

Tramadol can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing ULTRAM ER in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.

ULTRAM ER could be abused by crushing, chewing, snorting, or injecting the dissolved product. These practices will result in the uncontrolled delivery of the opioid and pose a significant risk to the abuser that could result in overdose and death (see WARNINGS and Drug Abuse And Addiction).

Concerns about abuse, addiction, and diversion should not prevent the proper management of pain. The development of addiction to opioid analgesics in properly managed patients with pain has been reported to be rare. However, data are not available to establish the true incidence of addiction in chronic pain patients.

Healthcare professionals should contact their State Professional Licensing Board, or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product.

Interactions with Alcohol and Drugs of Abuse
Tramadol may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression.

Drug Abuse And Addiction
ULTRAM® ER is a mu-agonist opioid. Tramadol, like other opioids used in analgesia, can be abused and is subject to criminal diversion.

Drug addiction is characterized by compulsive use, use for non-medical purposes, and continued use despite harm or risk of harm. Drug addiction is a treatable disease, utilizing a multi-disciplinary approach, but relapse is common.

“Drug-seeking” behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). “Doctor shopping” to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.

Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances. ULTRAM ER, like other opioids, may be diverted for non-medical use. Careful record- keeping of prescribing information, including quantity, frequency, and renewal requests is strongly advised.

Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, and proper dispensing and storage are appropriate measures that help to limit abuse of opioid drugs.

ULTRAM ER is intended for oral use only. The crushed tablet poses a hazard of overdose and death. This risk is increased with concurrent abuse of alcohol and other substances. With parenteral abuse, the tablet excipients can be expected to result in local tissue necrosis, infection, pulmonary granulomas, and increased risk of endocarditis and valvular heart injury. Parenteral drug abuse is commonly associated with transmission of infectious diseases such as hepatitis and HIV.

Risk of Overdosage
Serious potential consequences of overdosage with ULTRAM ER are central nervous system depression, respiratory depression and death. In treating an overdose, primary attention should be given to maintaining adequate ventilation along with general supportive treatment (see OVERDOSE).

Use in Renal and Hepatic Disease
Impaired renal function results in a decreased rate and extent of excretion of tramadol and its active metabolite, M1. ULTRAM ER has not been studied in patients with severe renal impairment (CLcr < 30 mL/min). The limited availability of dose strengths and once daily dosing of ULTRAM ER do not permit the dosing flexibility required for safe use in patients with severe renal impairment. Therefore, ULTRAM ER should not be used in patients with severe renal impairment (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION). Metabolism of tramadol and M1 is reduced in patients with advanced cirrhosis of the liver. The pharmacokinetics of ULTRAM ER has not been studied in patients with severe hepatic impairment. The limited availability of dose strengths and once daily dosing of ULTRAM ER do not permit the dosing flexibility required for safe use in patients with severe hepatic impairment. Therefore, ULTRAM ER should not be used in patients with severe hepatic impairment (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION).

PRECAUTIONS
Acute Abdominal Condition
The administration of ULTRAM ER may complicate the clinical assessment of patients with acute abdominal conditions.

Use in Drug and Alcohol Addiction
ULTRAM ER is an opioid with no approved use in the management of addictive disorders. Its proper usage in individuals with drug or alcohol dependence, either active or in remission, is for the management of pain requiring opioid analgesia.

Carcinogenesis, Mutagenesis,Impairment Of Fertility
No carcinogenic effect of tramadol was observed in p53(+/–)-heterozygous mice at oral doses up to 150 mg/kg/day (approximately 2-fold maximum daily human dose [MDHD] of 400 mg/day for a 60 kg adult based on body surface conversion) for 26 weeks and in rats at oral doses up to 75 mg/kg/day for males and 100 mg/kg/day for females (approximately 2-fold MDHD) for two years. However, the excessive decrease in body weight gain observed in the rat study might have reduced their sensitivity to any potential carcinogenic effect of the drug.

Tramadol was not mutagenic in the following assays: a bacterial reverse mutation assay using Salmonella and E. coli, a mouse lymphoma assay (in the absence of metabolic activation), and a bone marrow micronucleus test in mice. Mutagenic results occurred in the presence of metabolic activation in the mouse lymphoma assay. Overall, the weight of evidence from these tests indicates that tramadol does not pose a genotoxic risk to humans.

No effects on fertility were observed for tramadol at oral dose levels up to 50 mg/kg/day in male and female rats (approximately equivalent to MDHD).

Pregnancy
Teratogenic Effects: Pregnancy Category C
Tramadol was not teratogenic at oral dose levels up to 50 mg/kg/day (approximately equivalent to MDHD) in rats and 100 mg/kg (approximately 5-fold MDHD) in rabbits during organogenesis. However, embryo-fetal lethality, reductions in fetal weight and skeletal ossification, and increased supernumerary ribs were observed at a maternal toxic dose of 140 mg/kg in mice (approximately 2-fold MDHD), 80 mg/kg in rats (2-fold MDHD) or 300 mg/kg in rabbits (approximately 15-fold MDHD).

Non-teratogenic Effects
Tramadol caused a reduction in neonatal body weight and survival at an oral dose of 80 mg/kg (approximately 2-fold MDHD) when rats were treated during late gestation throughout lactation period.

There are no adequate and well-controlled studies in pregnant women. ULTRAM ER should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonatal seizures, neonatal withdrawal syndrome, fetal death and still birth have been reported during post-marketing reports with tramadol HCl immediate-release products.

Labor and Delivery
ULTRAM ER should not be used in pregnant women prior to or during labor unless the potential benefits outweigh the risks. Safe use in pregnancy has not been established. Chronic use during pregnancy may lead to physical dependence and post-partum withdrawal symptoms in the newborn (see Drug Abuse And Addiction). Tramadol has been shown to cross the placenta. The mean ratio of serum tramadol in the umbilical veins compared to maternal veins was 0.83 for 40 women treated with tramadol HCl during labor.

The effect of ULTRAM ER, if any, on the later growth, development, and functional maturation of the child is unknown.

Nursing Mothers
ULTRAM ER is not recommended for obstetrical preoperative medication or for post- delivery analgesia in nursing mothers because its safety in infants and newborns has not been studied. Following a single IV 100-mg dose of tramadol, the cumulative excretion in breast milk within sixteen hours postdose was 100 µg of tramadol (0.1% of the maternal dose) and 27 µg of M1.

Pediatric Use
The safety and efficacy of ULTRAM ER in patients under 18 years of age have not been established. The use of ULTRAM ER in the pediatric population is not recommended.

Geriatric Use
Nine-hundred-one elderly (65 years of age or older) subjects were exposed to ULTRAM ER in clinical trials. Of those subjects, 156 were 75 years of age and older. In general, higher incidence rates of adverse events were observed for patients older than 65 years of age compared with patients 65 years and younger, particularly for the following adverse events: constipation, fatigue, weakness, postural hypotension and dyspepsia. For this reason, ULTRAM ER should be used with great caution in patients older than 75 years of age (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION).

Brand Name: Ultram ER
Generic Name: Tramadol HCl Extended-Release
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