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No More Letting Go -- The Spirituality of Taking Action Against Alcoholism and Drug Addiction by Debra Jay, Clinical Interventionist © 2006
(Bantam Dell: New York, NY) All rights reserved. [293 pages]
[Answer 28 of 40 questions to receive 14 hours of Continuing Education credit]

PART ONE: QUESTIONING OUR ASSUMPTIONS
Hitting Bottom (p. 7-10)

1. The premise of "hitting bottom" is this: Allow addicts to reach a level that is so low that they finally come to their senses and become sober, or they immediately seek treatment. But the author recommends that families _______ before the alcoholic hits bottom and probably dies.
a. give an ultimatum
b. hospitalize the alcoholic
c. raise the bottom
d. put the alcoholic on lock down

Fooling the Mind (p. 11-15)
2. An alcoholic who says that his real problem is with depression is
a. being logical.
b. using misdirection
.
c. just being honest.
d. beginning to heal.

Addiction Isn't a Lifestyle Choice (p. 16-21)
3. Alcoholism is a genetically based disease that erodes a person's willpower.

a. True
b. False

Detachment and Inaction: Are They Synonymous? (p. 22-25)
4. The author defines "detachment" as

a. doing nothing until the addict comes to his senses.
b. spending more time away from the addict.
c. deliberately avoiding the addict, even when in the same house.
d. a willingness to take action without guaranteeing success.

Detachment and the Brain (p. 26-30)
5. When our loved one comes home drunk, the amygdala tells us we must do something, while the pre-frontal cortex helps us to think about what to do, before we do it.

a. True
b. False

When Do We Let Go and Let God? (p. 31-35)
6. Learned helplessness occurs in family members when they
a. have prolonged stress.
b. never know what the alcoholic will do next.
c. have a sense of having no control.
d. All of the above

It Is Everyone's Business (p. 36-41)
7. Family members will often say of an addicted loved one, "It is her responsibility to get better, not mine." But addiction robs a person of willpower and self-control. And alcoholics don't wake up one day and proclaim it's a good day for recovery. What parable in the New Testament does the author use to show that alcoholism is every family member's business?

a. The Good Samaritan
b. The Lost Sheep
c. The Prodigal Son
d. The Sheep and the Goats

Seeming to Do Is Not Doing (p. 42-46)
8. The common thread among families coping with a loved one's addiction is the belief that _____ will render the addiction unnecessary. Problems in the addict's life, it is believed, are what caused the addiction, not the other way around. If the problem is solved, it is reasoned, the addiction should go away on its own. Everyone is confident that by giving an addict a fresh start, he can build a new life. We expect addicts to get their heads straight. But therein lies the problem. Addiction takes over two things: one's brain, and one's soul. Addicts cannot rely on the strength of their minds and spirits because these areas are crippled.

a. long-term persuasion
b. improving the addict's circumstances
c. professional counseling
d. demonstrating love and compassion

Create a Spacious Place (p. 47-50)
9. The main reason why family members refuse to cooperate with the rest of the family in helping the alcoholic is because they are

a. usually too busy.
b. wounded.
c. worn out.
d. apathetic.

PART TWO: THE COLLAPSED SPIRIT -- INACTION AND OLD ACTION
Old Actions Perpetuate the Past (p. 53-58) (No Question)

The Art of Contortion (p. 59-64) (No Question)
Fear (p. 65-71)

10. Addiction produces an ongoing fear of "I-don't-know-what-is-going-to-happen-next." When fearful conditions persist and we believe we have no power to change them, we adjust ourselves by normalizing what is abnormal. This leads to prolonged stress which is destructive because we are not made to live in a constant state of fear, and our bodies release adrenalin and cortisol over too long of a period of time. What is the effect of prolonged fear and stress on our bodies?

a. Higher levels of cortisol produce a weakened immune system, loss of hair, thinning of our skin, decreased muscle mass, and lack of energy.
b. A drop in serotonin levels, decrease in self-control, depression, and insomnia.
c. A greater probability of stroke, diabetes, heart attack, high blood pressure, and osteoporosis.
d. All of the above.

Anger (p. 72-76)
11. "Positive anger" leads to

a. forming a team who can help encourage the addict into recovery.
b. telling the addict you will leave if he doesn't get help; and then not leaving.
c. allowing the addict to drive your kids to baseball practice, after a few days of sobriety.
d. believing what the addict promises he will do.

Perfectionism (p. 77-81) (No Question)

Caretaking (p. 82-87)
12. The golden rule of Christianity says, "Whatever you wish that men would do to you, do so to them." To properly apply this to an addict, his family members must ask themselves, "How would I want my family to respond to me if I was addicted?"
a. True
b. False

Procrastination (p. 88-93)
13. Procrastinators delay making critical decisions to get their loved one into treatment. They often delay taking action because they _______.
a. are confused by so many treatment choices.
b. don't have the money for residential treatment centers.
c. fear retaliation from the addict.
d. can't guarantee a sober outcome.

Blame (p. 94-98)
14. What actually happens when family members blame one another is

a. each member realizes ways they can improve their behavior.
b. family care-giving roles become more clarified.
c. members usually confess their short-comings to one another.
d. the focus is taken off the real problem: drinking.

Two Sides of the Same Coin (p. 99-105)
15. The health problems of non-drinking family members caused by the stress of living with an alcoholic are almost always ____ to the diseases caused by alcoholism to the alcoholic.

a. identical
b. different
c. less than
d. unrelated

Breathing New Life into the Spirit (p. 106-109) (No Question)
The Withered Brain (p. 113-118)
16. When prefrontal cortex activity is depressed, as it is in alcoholics, the result is a diminished sense of right and wrong, an inability to learn from past mistakes, and a decrease in concentration and likewise increased distraction. ______ properly exercises the prefrontal cortex, and recovering alcoholics mature rapidly and begin experiencing normal emotions.
a. Doing intensive, daily study of the damage done by alcohol abuse
b. Working a 12-step program of recovery

c. Going to regular counseling
d. Not drinking anymore even without a recovery program

17. Alcoholism affects the temporal lobes and the limbic system of the brain. These constitute the emotional brain. Alcohol stunts the brain's ability to develop emotionally and socially. The emotional age of alcoholics correlates to the age when they began using alcohol. If they started drinking at age thirteen and get sober at age forty-five, they have the emotional maturity of a
a. thirteen-year old.
b. forty-five year old.
c. eighteen year old.
d. twenty-one year old.

Disrupted Decision Making (p. 119-123)
18. Which of the following is NOT true?

a. Families often believe that when alcoholics are sober, their thinking is normal, and their brains are altered only when they are actively using drugs. But the alcoholic brain does not return to normal in between periods of alcohol use.
b. With ongoing recovery, most of the damage to the brain is reversed over time.
c. The human brain is not fully developed until the age of twenty-one, which is why teenagers do not always show good judgment or learn from the consequences of their actions.
d. Alcoholics Anonymous does not teach how to handle one's drinking. It teaches how to handle one's sobriety.

The Genetic Factor (p. 124-129)
19. For those who are genetically predisposed to addiction, their brains don't care why they drink. The only thing that matters is whether or not alcohol enters their bodies. What makes scientists so sure that addiction is inherited?
a. Identical twins (same genes) are more likely to match each other in either both becoming alcoholics or both not becoming alcoholics. Fraternal twins were more likely to differ, where one became and alcoholic but the other did not.
b. Children born of alcoholic parents and then adopted to non-alcoholic parents are four times more likely to become alcoholic than children born of non-alcoholic parents and then adopted to non-alcoholic parents.
c. Geneticists have determined that a child born of an alcoholic parent has a 50% chance of inheriting the genes for alcoholism.
d. All of the above.

Predictable, Progressive, and Chronic (p. 130-136)
20. Which is TRUE?

a. Alcoholism always gets worse if left untreated.
b. There is no cure for alcohol addiction (although it can be managed). Therefore, alcoholics cannot successfully return to social drinking. Recovery requires abstinence from all mood-altering drugs.
c. Researchers in Finland found that the only common denominator among people who remained sober ten years after treatment was their ongoing involvement in a 12-step recovery group.
d. All of the above.

Choice and Responsibility (p. 137-144)
21. Which is NOT true?
a. If an alcoholic does not want to get well, it is because his disease keeps him from wanting to get well.
b. A child who reaches the age of twenty-one without smoking, abusing alcohol, or using drugs is virtually certain never to do so.
c. The average age at which Americans begin drinking is fifteen.
d. One of every four alcoholic beverages in America are consumed by underage kids. And one of every five children between ages twelve and twenty is a binge drinker.
e. An alcoholic's brain confabulates, unconsciously replacing fact with fantasy when necessary.
f. Addiction is NOT a mental illness.
g. The disease of alcoholism tells the alcoholic, You are still in control. You still have more time.
h. Alcoholics cannot identify their own delusional thinking.

The Mantras of the Addicted Brain (p. 149-153)
22. Which was NOT listed as a mantra used by alcoholics?

a. Alcohol and other drugs don't cause my problems.
b. Alcohol and other drugs are a solution.
c. I'm so special, so unique, and so smart, I don't fit into normal society (so the rules don't apply to me).
d. I am in control and I have more time.
e. I'm a better person when I drink or drug (sexier, funnier, smarter, more creative, better-looking, more fun to be around).
f. I cannot successfully manage my drinking without help from God and others.

Spiritual Awakening Changes the Brain (p. 154-160)
23. The best known method for staying sober

a. are the 12 Steps of Alcoholics Anonymous
.
b. is daily medication and weekly Cognitive-Behavioral Therapy (CBT).
c. is spending 90 days in an inpatient treatment rehab.
d. is having a one-time, rapturous experience of having the love of God wash over you for 30 minutes.

Getting Ready Requires an Act of Faith (p. 163-167)
24. Which of the following statements does the author believe is TRUE?

a. You can't help an alcoholic until he wants help.
b. If the alcoholic wants to drink its none of our business.
c. He has to hit bottom before he will go to treatment.
d. You don't have to feel ready to take action. You just have to do what is right.

Intervention: The Road to Integrity (p. 168-174)
25. If an alcoholic calls a family member and wants to leave treatment before he is well, the family member should

a. hang up the phone without responding.
b. allow the alcoholic to come home because the treatment center is apparently not helping him.
c. allow the alcoholic to come home if he promises not to use alcohol.
d. tell the alcoholic he cannot come home until he completes his treatment.

Spiritual Negotiation (p. 175-181)
26. ________ differentiate between the disease of addiction and the person suffering from it. They know how to work toward recovery without supporting the addiction. They recognize that the person with the disease is NOT the disease. They say, "I love you. The disease is not you, but it hurts you and it hurts me." Instead of using anger, judgment, or blame, they use love, compassion, honesty and a vision for the future.

a. Ambassadors
b. Aggressors
c. Appeasers
d. Avoiders
e. Analysts

Coming Together: Family Intervention (p. 182-189)
27. About ____ percent of family interventions motivate the addicted loved one to accept treatment the same day.

a. 55
b. 65
c. 75
d. 85

A Checklist: Preparing for Family Intervention (p. 190-199)
28. Which is NOT true about an intervention letter?

a. Alcoholics tend to interrupt when intervention letters are read.
b. The longest part of the letter is the love section, where we tell the alcoholic how much she is loved.
c. The honesty section identifies alcoholism as the enemy. This is done without anger, judgment, or blame.
d. The hope for the future section tells alcoholics about the goodness of sobriety, their purpose in life, their dreams, the good they can do for others, why we need them, and ends with “Will you please accept the help we are offering you today?”

Intervention: A Dramatization (p. 200-210) (No Question)
Intervention in the Workplace (p. 211-216)

29. Workplace interventions _________.
a. are only successful when conducted by professional interventionists.
b. are usually unsuccessful.
c. are almost always successful given that most people want to save their job.
d. often result in dismissal of the alcoholic employee.

Medical Intervention (p. 217-223)
30. Which is NOT true?

a. Few doctors are well-educated about addiction, and some know less than the general public.
b. Most health professionals still view alcohol addiction as a willpower or conduct problem, not as a disease.
c. Most doctors do not have a working understanding of intervention or treatment.
d. It is more effective for a doctor to confront his alcoholic patient alone than for the family to do an intervention.

Legal Intervention (p. 224-230)
31. Which is NOT true?

a. Writing a letter to a judge who will preside over your son's DUI court case and asking the judge to mandate your son into ninety days of residential treatment could save himself and others.
b. If you are not allowed to attend an alcohol assessment for your family member, there's nothing you can do to let the assessor know the true drinking history of your loved one.
c. If an alcoholic threatens suicide, you can have him or her committed to a psychiatric hospital.
d. According to a letter written by a recovering alcoholic, we should not believe what an alcoholic says.

Soft Intervention (p. 231-236)
32. Which is NOT advice given in this chapter?

a. Stop reacting to the alcoholic.
b. Don't lie, cover up, or make excuses.
c. Do not go to Al-Anon meetings.
d. Don't make empty threats. Set boundaries instead.
e. Stop taking on responsibilities that belong to the alcoholic.
f. Do not give money or loan money to alcoholics.
g. Don't bail alcoholics out of jail, pay fines, or hire lawyers.
h. Don't drink with alcoholics.
i. Don't try to control someone's drinking by dispensing a daily supply of alcohol.
j. Do not do for alcoholics anything they would be capable of doing if they were sober.

Informal Intervention (p. 237-243)
33. Which is NOT a characteristic of an informal intervention?

a. Do it with only you and your alcoholic loved one present.
b. Stay calm, even if the addict becomes angry.
c. Only talk to your loved one when he is sober.
d. Do not stir up shame.

Behavioral Intervention (p. 244-248)
34. If an alcoholic never responds and doesn't get sober, the CRAFT program asks: "When you have done everything you can to improve your life with your drinker and nothing has improved, it may be time to consider life without him or her." Does the author agree with this?
a. Yes
b. No

Impaired Professional Intervention (p. 249-255)
35. Which is NOT true about monitoring organizations?
a. Their purpose is to treat impaired professionals, not punish them.
b. They can help preserve the careers of doctors, lawyers, counselors, airline pilots, etc.
c. If impaired professionals turn themselves in to monitoring organizations, their chemical dependency must still be reported to their licensing board.
d. A family member can report a highly successful loved one with a drinking problem to a monitoring organization, who then can intervene for that family member and keep him or her anonymous.

Crisis Intervention (p. 256-260)
36. This chapter is about

a. helping an alcoholic out of a crisis before he goes into treatment.
b. helping an alcoholic out of a crisis only after he goes into treatment.

Success in Treatment is Time in Treatment (p. 261-266)
37. Which is NOT true?

a. The Salvation Army has treatment centers throughout the United States.
b. Many people get sober through Alcoholics Anonymous and their 12-step groups.
c. Insurance does not pay for halfway houses, but they are very affordable.
d. Only the wealthy can afford the best treatment programs.

"An addict's brain does not heal in 30 days of treatment or four months at a halfway house. The behavior control centers are still burnt out. The brain must work harder to control behavior. Environmental cues trigger drug cravings at an unconscious level. Profoundly powerful cravings in the area of the brain responsible for emotional memory. The addict is blindsided by these memories, which take over body, mind, and soul. The brain's decision-making regions are still defective. Judgment is poor. In many cases, choices are made without regard for harm or punishment and with no thought to the future. These brains still have trouble learning from past mistakes. Addicts cannot trust their own brains. To keep from relapsing, they must "follow the directions" or listen to what other people tell them to do if they hope to stay sober. A relapse agreement helps alcoholics to follow the directions." (pp. 267-268)

Formulating A Relapse Agreement (p. 267-271)
38. If an alcoholic is following all the directions, working a strong program of recovery, and still relapses, what can be done to help her?

a. Meet with an addiction specialist.
b. Determine if the addict is wholeheartedly working the program.
c. Find out what types of additional support she needs.
d. All of the above.

Spiritual Action (p. 275-282)
39. The best way for alcoholics to quickly rid themselves of the negative emotions of resentment, guilt, remorse, anger, and worry is to

a. attend the next AA meeting.
b. rehearse the 12 Steps.
c. get busy doing something productive.
d. admit their wrong-doing right away.

In the Beginning (p. 283-288)
40.What did Bill Wilson conclude that he needed to do in order to stay sober?

a. to talk to another minister
b. to talk to another alcoholic
c. to talk to his wife
d. to talk to a doctor