David Altshuler, M.S.
(305) 978-8917 | david@davidaltshuler.com

Happy, Happy, Joy, Joy!

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Sixteen year-old Paula is unhappy at her rehabilitation facility in California.

She was happier last year before ending up in treatment. She was happy when she was running away from home, getting into cars with strange adult men, staying away for days at a time, binge drinking, and using IV drugs.

Paula has been making some slow progress in treatment. OK, let's be honest: she's barely making any progress at all. She doesn't "get it," that drugs were destroying her life, that her future outside of treatment was time limited, that the issue was not "if" but "when" something truly terrible happened. (By this high standard of truly terrible, her STD doesn't even make the list.)

Still, where there's life there's hope and where there's sobriety--even enforced sobriety--nothing truly terrible happens in a given day. Paula may not be making significant strides therapeutically, but she's not popping Oxycontin with vodka chasers either. At least she's not waking up next to who knows whom having done who knows what.

Paula's treatment team and I agree: Paula is a severe substance abuser, probably an addict. She's different from many folks, those for whom an occasional drink is a pleasure not an issue. Some people can even drink a six pack of beer and not have a problem with alcohol. I would argue that Paula is not one of those people. I feel strongly that if Paula drinks, Paula will die. Stated unequivocally, as a direct and foreseeable result of her drinking and drugging, Paula will die an early death. I'm not much for making predictions but I doubt she'll see her 25th birthday.

Paula has complained to her parents back in Virginia that she isn't making any progress in treatment. And the school at the treatment center is even worse she says. The chemistry class is too hard and the English class is too easy. Some of the other girls on the cross country team don't take running seriously enough and other girls take the sport too seriously.

Paula's parents are furious with me. In our weekly phone calls, they point out Paula's lack of progress; they blame me for recommending this expensive facility; they speak, at length, about how insensitive Paula's chemistry teacher is and how incompetent her English teacher is. They tell me how, were Paula not in treatment, she would likely be running 5K in under 24 minutes instead of her current best time of 25:20.

Paula's parents are agreed that yes, perhaps, Paula needs to cut down on her alcohol use and that, indeed, she probably shouldn't use illegal drugs for a while, but why am I insisting that Paula can't ever drink again, that she can't even have a glass of champagne at her wedding? Why am I so mean? Why can't Paula have her old life back minus the drugs and alcohol? Why does she need to be in treatment if treatment just isn't working? Why won't I recommend that she come home to be with her loving parents who miss her terribly?

My argument, that every day that Paula is sober, she learns another way to get through the day without using, falls on deaf ears. It's true that she's not making great progress internalizing her other issues; it's true she still had trouble regulating her mood and that her eating disorder isn't getting any better; it's true that she's not learning much chemistry and that her English class may be too easy. My point that at least she's alive, seems not to resonate with her parents.

Paula's parents want her to be happy. They are going to pull her out of treatment and bring her home.


Imagine staring at an object on a distant horizon. You are unable to discern any detail on the far away ship; it's just too far for you to see clearly. The more you try to focus, the more obscured the far-away vessel becomes. Finally, you glance away, and look a few degrees to one side. As unlikely as it sounds, you are now able to see the ship more clearly--even though you've stopped trying to see it directly.

Nothing is harder that seeing our beloved children unhappy. But focusing on our children's happiness is the least effective way to allow them to find contentment and fulfillment. Indeed, happiness is a hard deer to hunt.

Which child is more likely to be happier? One child is given a huge home complete with finished granite counter tops in the kitchen, immaculate walk-in closets, and a polished marble staircase. The other child is given the tools and materials to build his own home. In addition, this child is told by his father that they will work together to build the house although the project may take a couple of years and will require significant hard work and sacrifice. It is likely, that over the course of the project, the father and son may drop tools on their feet, argue, and use inappropriate language.

If you agree that the first child--the one who is given a perfect home--will be happier, do you also agree that Paula's parents should take her home so that she will be happier?

If you agree that the second child--the one who will take time to work with his dad on building the home--will ultimately be more content, do you also agree that there may be some unhappiness and frustration during the construction project?

And that it's OK for our kids not to be happy on a given day?



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