I wrote an email to Oprah. Her address is firstname.lastname@example.org. Some of the attachments from the email are included as Adobe pdf images following the text in this post. The Cisco Synopsis follows.
Your daily talk show has inspired many, including myself. But I am troubled at something you said. While interviewing Ralph Lauren you asked about his inspiration for design. He said, and I paraphrase, he would not likely design an outfit for a particular person – but rather designs for an event or situation. You became animated and exclaimed, “You tell a story.” I also like story. I appreciate good interpretive literature which leaves one with a better sense of humanity. But story, or narrative, is not science. Narrative does not answer all questions with specific information. On your farewell show you talked of people’s sense-of-worth or sense-of-self as critical to understanding illnesses such as addiction. Actually, I think you strongly implied that addiction comes from a sense of worthlessness. You have unwittingly promoted a faulty narrative science. The Narrative Science of the mid-to-late Twentieth Century has been proven wrong. Anyone who promotes the narrative science of addiction is doing a grave disservice to some very sick people, people who are dying every day.
This is not just my thought – the actual science of addiction therapy has identified the major myths of the addiction narrative. This is well documented by the United States Department of Health and Human Services (HHS). The Treatment Improvement Protocol (TIP) Series Number 35, published by HHS, titled “Enhancing Motivation for Change in Substance Abuse Treatment” is very clear on three myths which are central to the addiction narrative. The Addictive Personality is a myth, Robust Denial is a myth, and harsh confrontation as an appropriate counseling style is a myth (see attachment). Professional trainers in mental health and addiction therapy note that new findings take about twenty years to reach the front line treatment process. The Mythology of the Addiction Narrative was first presented by HHS in 1999 – and the retraining of treatment professional is behind schedule.
Treatment protocols based on the mythology are cruel and inhumane. I have personally witnessed the ill treatment of clients diagnosed with addiction. These ill-treatments are well defined in the Motivational Interviewing attachment.
Two asides – President Obama struggles with a nicotine addiction – is this addiction rooted in a low sense of self? I taught Anger Management at our local Community Mental Health Center. Self-concept is a major component in the equation of anger management and a variety of other mental health problems. Self-concept is not to be discounted – but neither is it to be tagged as the central problem of addiction or other illnesses.
Why do people feel the need to find the root cause of addiction? Perhaps it is just the nature of man – but we have to note that we do not know the cause of Heart Disease or Diabetes or Arthritis. We know symptoms like high blood pressure or high cholesterol or being tired or high sugar measurements in our urine. We also know that all chronic illnesses, whether we know the cause or not, have to be treated with life style changes – and sometimes medication.
Addiction is considered a disease, like heart disease, because it has identifiable symptoms and identifiable treatments. The treatments include life style changes. In AA they have a term: HALT. They say HALT, don’t get hungry, angry, lonely, or tired. This could as easily be applied to a heart patient. Physicians have identified stress as a condition which aggravates heart disease – but stress does not cause heart disease. The same can be said of substance abuse.
Addiction is not the same as obsessive-compulsive disorders. By lumping a vast array of mental health disorders into the same category we do a grave disservice to many suffering individuals.
Oprah – someone with your power and influence cannot legitimately promote incorrect thinking – thinking that is promoting old stereotypes of alcoholics. Here is a typical stereotype: “He drinks to self-medicate because he has poor coping skills and basically a low sense of self-worth.” A better (and more accurate) statement might be: “He drinks because he is an alcoholic.” In my work with the Community Mental Health Center I have heard people say, “I shoplift because I am an alcoholic and that is our nature,” and, “I get angry because I am an alcoholic and I don’t cope well.” Where do you suppose someone would get goofy ideas like that? (Is goofy an appropriate mental health term – or is it a tool of narrative designed to bias thought processes?)
One more example of narrative masquerading as science: For two millenniums the narrative said the Sun revolved around the Earth. When the narrative was challenged by scientists such as Copernicus and Galileo the protectors of the narrative demonized the science and the scientists. Don’t laugh or discount the example – that same scenario is playing out today in the field of addiction treatment. You have inadvertently become a part of the protective shield around the addiction narrative. History will identify you as such.
On January 14, 2009, I wrote a letter to President Elect Obama and HHS nominee Tom Daschle with my concerns about the progress of implementing new science in addiction treatment. The letter was forwarded to the Ivette A. Torres, M.ED., M.S., the Associate Director for Consumer Affairs for HHS Center for Substance Abuse Treatment. She promptly responded with bureaucratic statistics, saying, “In FY 2008, data show that at follow-up: 62% were abstinent from substance use, 54% were employed, 47% were stably housed, 96% had no CJ involvement and 68% experienced no social/behavioral consequences due to their use. These data all show a positive trend from intake to treatment to six months post.” Oprah – I read these statistics as astounding failures of addiction treatment. Statistics such as these in any other medical treatment protocol would be cause for alarm in the entire medical community. HHS either completely missed my point – or chose to deflect attention with blabbering statistics. Her entire letter is attached.
Frustrated with breaking through the bureaucracy I wrote a novel assailing the addiction narrative. Fight fire with fire – or in this case – fight narrative with narrative. The novel is not yet published but I have attached a file with an author bio, synopsis, and sample writing – this is the material sent to prospective literary agents. The title is “Cisco” and deals with one man’s addiction struggle. I have also written extensively on this subject on my on-line magazine.
This email is not about me – it is not about my novel – it is not about HHS or President Obama. I am frustrated with the bureaucracy which stalls the introduction of new science. And I am frustrated with talk shows which continue to promote outdated narratives of mental and physical health.
Here is the important point: Inventing causes of diseases with narrative does not serve the treatment of the disease. Basing medical treatment on narrative science is the equivalent of NASA designing their future projects based on Isaac Asimov’s Foundation Trilogy.
Please understand that many of us respect your service to humanity. The intention of this correspondence is to again try to bring new science to the still suffering addict.
Ohg Rea Tone
Addiction sweeps America. Prison populations are at all time highs. Several theories of substance abuse treatment compete. Conspiracies by authorities in the Criminal Justice System serve to incarcerate anyone deemed an addict. Cisco is sixty years old and has a history of prison and failed attempts at rehabilitation; he is charged with second degree murder. The prosecution uses the concept of an addictive personality, defined as criminal thinking, as motive in the crime. Controversy abounds. The intrigue surrounds late night meetings at the Courthouse with the Prosecutor, Presiding Judge, Prison Warden, and President of the local Community Mental Health Center. Methods of addiction treatment have real consequences for those in the criminal justice system, and how the criminal justice system views addiction.
The story unfolds in the Council Chambers at City Hall in St. Adelaide, Missouri. The County Coroner has chosen the Council Chambers for his Inquest because it is the only venue available with courtroom functionality, with accommodations for a large audience of spectators. The Coroner is an independent judicial officer of the State, not directly associated with the Circuit Courts. All Coroner’s Inquests are open to the public.
The facts of this case are generally not in dispute, but motive is. A female jogger was attacked by a young mentally disturbed man, an older male walker came to her rescue, a scuffle ensued, the attacker died in the scuffle. The Coroner was prepared to issue a Certificate of Death with Justifiable Homicide as the cause.
The County Prosecutor filed second degree murder charges before the Coroner ruled on manner of death. The Coroner, suspecting back room political motives or simply vengeance against the accused, called for an official Inquest. There are few legal rules as mandated by a Circuit Court Trial – The Coroner can stage whatever forum he deems appropriate, and allow whatever evidence, to finding truth. In this case the Coroner subverted the legal process of the Prosecutor in order to find the truth. The Prosecutor and the accused both agreed to the Inquest format. The Prosecutor agreed that if Justifiable Homicide is found he will drop the murder charges.
Six Jurors were randomly selected from the community. A court reporter will record the proceedings. The coroner and prosecutor both agree to accept the jury recommendation.
Rarely is there an actual defendant in a Coroner’s Inquest. Usually the actual cause of death is evident. The task of the jury is to determine manner of death – whether suicide, homicide, accident, or natural. That is the question raised by the County Prosecutor in this case. The Coroner has decided to allow the Prosecutor to present his view. The defendant can present his story.
The County Prosecutor believes this death was intentional and unnecessary. In this particular Inquest two Sheriff’s Deputies are on hand. The Prosecutor has already filed second degree murder charges. At the preliminary hearing the case was bound over for trial – with no bond for the accused. The accused is remanded to custody.
The defendant, Harley Cisco, is a sixty-year-old ex-convict, fifteen years for one charge of vehicular manslaughter and one charge of felony vehicular assault. The felony charges stemmed from drinking and driving. While in prison he was ordered twice to complete their 120 Day Drug and Alcohol Program – he was kicked out each time.
Prior to prison Cisco had a small rap sheet, including possession of marijuana and misdemeanor assault. He was intoxicated at the time of the assault. After the assault charge he was ordered to attend Drug and Alcohol Treatment at the local Community Mental Health Center. He left the program after one night. The marijuana charge also was met with a charge to again attend a treatment program. He was kicked out a second time.
A mentally disturbed attacker is dead. Cisco is initially considered a hero, heralded as such on national cable news – until his past is highlighted by the local prosecutor. The death of the young mentally ill man was from three different mortal blows – which the Prosecutor and Medical Examiner both believe were intentional and well executed.
The Prosecutor believes Cisco struck his first mortal blow, and then proceeded to intentionally kill the mugger with two more strategic mortal shots – for personal satisfaction.
The story unfolds with witnesses from the Medical Examiner’s office, the police, paramedics, Hospital ER personnel, a Prison Warden, the local Director of the Community Mental Health Center Alcohol and Drug Treatment Program, the Presiding Judge of the Fifth Circuit and Administrator of the local Drug Court, and the Elementary School Teacher of Cisco’s grandson. In every case the Prosecutor will interpret the testimony in light of an addictive personality. The interpretation is consistent with modern criminal justice treatment programs.
The testimony from several witnesses, including the police, paramedics, and Medical Examiner is chronicled as modern Crime Scene Investigation, with details and conjecture.
The case builds on evidence of the character of Cisco, suggesting this is a man who would kill again if given a chance. The prosecutor’s case rests on the concepts of Addictive Personality, denial, poor impulse control, immaturity, defiance, aggression, and confrontation in counseling. The novel challenges these concepts as applied in addiction treatment.
Protestors are in town from the National Council of Christian Churches. The National Council of Christian Churches argues that modern mental health strategies do not allow for the simple consideration of sin, and the right of true Christians to defend their beliefs. The NCC also makes a case against twelve step programs, noting that a one step program is the solution – the one step is acceptance of Jesus as Savior.
Cisco is called as the last Prosecution witness. Prosecutor Sprague is confident Cisco will expose his irrational addictive thinking – so he merely asks Cisco address his history of failed treatments and prison life. Sprague verbalizes his interpretation of addictive thinking to the jury. He then asks Cisco to tell his story of what happened on the Urban Trail. Again, everything Cisco says is interpreted in the context of Criminal Thinking. The Prosecutor believes that the Addictive Personality and Criminal Thinking are mutually inclusive.
Watching the trial from an internet feed in Washington DC is the Director of Mental Health for the United States Department of Health and Human Services, Dr. Kevin McGonagall. He orders his plane ready and flies to St. Adelaide. Dr. McGonagall takes a seat beside Cisco and Cisco’s liberal Parole Officer and offers his assistance, asking Cisco to call him as a witness. Cisco agrees and Mr. McGonagall takes the stand to dispute the claims previously made by local mental health authorities. Mr. McGonagall will challenge myths of addiction treatment, including Addictive Personality, denial, and confrontation as an effective counseling strategy. Mr. McGonagall will surmise that Cisco may perhaps have never killed anyone because of a DWI if Cisco had had proper treatment – directly confronting the prosecution.
The last witness will be the daughter of the man who died in Cisco’s manslaughter conviction. She will appear as a witness for the defense.
Concurrent to the Inquest proceedings is a Group Conscience meeting of Alcoholics Anonymous. The AA members debate the treatment philosophies presented at the Inquest as compared to the beliefs of AA.
The story concludes with the Coroner turning the case over to the Jury.
The completed novel is nearly 71,000 words – 258 pages at double spaced 12 point font with one inch margins.