Recovery Now: Thank you Dr. Maria Pagano, and where do you work?
Dr. Pagano: I am Associate Professor in the Department of Psychiatry, Division of Child and Adolescent Psychiatry, at Case Western Reserve University.
Recovery Now: And would you tell us a little bit about your experience in the field of recovery and treatment?
Dr. Pagano: Sure. The focus of my research is on the role of service in helping the alcoholic or addict stay sober.
I've done more than 15 different studies looking at the role of helping others and how it helps the helper stay sober. I have a series of studies with adults, and I also have been following adolescents with addiction, to understand more the impact of helping others, the service component of a 12-step program.
Recovery Now: Yeah, I noticed a study on your website that followed adolescents and how consciousness influenced their recovery and how service influenced the success of their recovery. Could you expand upon that at all?
Dr. Pagano: Well, sure. Well, I would really need to start with the 12-step theory to explain the relevance of the findings. The theory is that alcoholics, addicts lack power, and alcohol spirits provided the power to live life on life's terms. It brought immediate ease and comfort, and that restlessness, irritability, discontent all went away once that alcohol or drug was consumed. And in recovery, a person still needs to live life on life's terms, but you no longer find alcohol or drugs working.
So the theory is that power now needs to come from a higher power of one's own understanding. And the 12-step program is designed for individuals to find a relationship with a higher power that can be that resource to live life happy, joyous, and free.
Service is essential for helping the alcoholic, addict stay sober because it's an instant reminder when one's helping another addict of what the consequences are when one picks up alcohol or drugs. But it's also a mechanism to get back to what's important in life and gratitude. And suddenly one's own problems aren't that, you know, important. When you're helping another person, you realize how good you actually have it.
And it also helps to make one realize you're not the center of the universe. So the egocentric thinking is minimized by helping others. By getting out of self when you help another person, you are no longer so self-absorbed, and you can see life is a lot bigger than your problems.
Recovery Now: So what are some of those qualities that one would recognize in a person as they change and achieve or attain a God consciousness?
Dr. Pagano: Right. So back to how does that line up with a God consciousness? So helping another person is one way in which you gain a sense of God consciousness, as one might frame it. There is a phrase: I sought my God. My God eluded me. I sought my brother, and I found, you know, what I was looking for-my God, myself, and thee.
So helping another person is a venue for having a sense of connectedness to a power of one's own understanding. So that's the link there, but, you know, God consciousness is much bigger than just service. Service is just one venue for attaining some interconnectedness to a power greater than oneself.
Recovery Now: What I love about what you're doing is that these theories are so, I don't know, theoretical, but you're putting, like, concrete statistical analysis, you know, wrapped around these spiritual concepts, and I think that's . . .
Dr. Pagano: Yes.
Recovery Now: . . . amazing. Would you expand upon how you're applying spirituality and statistics together?
Dr. Pagano: Well, sure. Again, luckily, other very bright scientists have developed valid instruments to assess these constructs, so I developed the Service to Others in Sobriety tool to measure the type of helping that in 12-step programs. But God consciousness, we use a tool developed by Dr. Lynn Underwood called the Daily Spiritual Experiences Scale, which is a very good tool because it doesn't require any particular denomination, and it has nothing to do with formal religion or practices but much more about your awareness of the divine in your daily living.
So, again, it's a tool that's allowed us to capture this, you know, ephemeral, if you would call it, sense of, you know, connecting to a power and the world around you.
Recovery Now: That's beautiful.
Dr. Pagano: Yes. So, again, we measure this. We have 200 adolescents that we are following, you know, from when they are starting treatment, their progress during treatment, and then 2 years following treatment. And we interview them at, you know, set time points and collect these measures so that we can with statistical modeling pull out what is driving what in terms of behavioral change.
Recovery Now: And where can people go to find all of the studies that you're developing and have published?
Dr. Pagano: Well, we do have a website. It's called helpingotherslivesober.org.
Recovery Now: And would you tell us about your mission with that website?
Dr. Pagano: Sure. You know, our mission again is to be understanding, you know, the role of service but other sort of mechanisms of behavioral change in 12-step programs of recovery that enable a recovering individual to stay sober and prosper, thrive, so to speak, in terms of living a good life.
Recovery Now: That's amazing.
Dr. Pagano: So helpingotherslivesober.org is our study website, and, you know, it's been a creative endeavor to create the website. I can't claim credit for it all. I've had very bright team members assist with its creation. So I do welcome input and . . .
Recovery Now: Excellent.
Dr. Pagano: . . . delivers the information where we're learning.
Recovery Now: Cool. I just want to switch gears a little bit just to speak more on adolescents. And, I don't know, what do teenagers seem to struggle with these days in regard to drug abuse and alcoholism with the glamorization of party drugs, dance culture, the almost legalization of marijuana in California and other states through medicinal things? So what's your stance or your opinion as to what the typical teenager these days is going through?
Dr. Pagano: Well, you know, I don't know if it's really that different than prior generations. What I hear a lot about is a sense of not fitting in, not belonging, and, again, like being the misfit syndrome is kind of what I would call it. That seems to be a pervasive theme, and alcohol and drugs took all that away, you know, and it allows one to be the life of the party, or, you know, no longer that inner angst is, you know, troubling one.
So the misfit syndrome, not belonging, not being cool, not knowing what to say, not getting the rules of life somehow, and everybody else has got it going on. So in recovery when you're surrounded in a fellowship with other people who feel like they also have been misfits, there's a bonding. I don't see any, you know, adolescent really being a misfit. It's more of an inner experience. But it's very real, and, you know, having a sense of mattering in this world, I don't really know if that ever goes away. Adults struggle with it as well, but it's particularly acute amongst adolescents.
Recovery Now: So would you say having the opportunity to be of service to others is a form of, you know, mattering in one's world?
Dr. Pagano: I think it directly attacks that misfit syndrome. When you help another person by sharing your dark past, that can be uniquely helpful to another person. You know, it becomes a very valuable tool and builds self-esteem, leadership, identity. It's a way to transform dark into good.
Recovery Now: So how did you get started in the field of recovery research and addiction treatment?
Dr. Pagano: You're asking great questions. Well, I mean, I've always been interested in the topic of generativity, which in psychology by Erik Erikson, one of the pioneers of the discipline, you know, it was presented as, you know, something in adulthood that, you know, grows as you get older. And I always thought, well, it seems to me that's an important, you know, behavior across a lifespan not just in adulthood. So that really kind of began my study of this.
And then when I was at Brown University in the Department of Psychiatry, I was training faculty for their addiction center, and I noticed that no one was studying the role of service. There was a lot of good work being done on medications and cognitive behavioral interventions, but there was nothing . . . no one was looking at the role of helping another person in 12-step programs as a viable method to help stay sober. And so it was really kind of again a good fit. I saw where I could be helpful in advancing the science to take a look at this, and so that's really where I began. And I came to Case and have been fortunate to be the only addiction researcher on the landscape of adolescents and have been able to really do some good work.
Recovery Now: Since you mentioned Case, what is Case exactly?
Dr. Pagano: Case Western. Yeah, Case Western Reserve University. It is in Cleveland, Ohio. It's most, you know, famous for its engineering school, but its top ranked in the nation for its federal grants received. It's a very rigorous institution, well supported for research. I'm in the School of Medicine, and, you know, I'm able to contribute to the scientific community with again this focus on the factors that really are influencing to adolescent addiction recovery.
Recovery Now: Excellent. You know, I think we've got it. So do you have any closing remarks or anything that you'd like to speak about?
Dr. Pagano: Sure. Well, again, on our study website, we have the largest collection of young people speaker tapes, and I think that's a resource I would like people to know about. There's nothing like learning straight from the mouth of an adolescent what it was like using, what happened in getting sober, and what being sober is like today.
I think it's a resource that parents, those who love a young adult with addiction could benefit from trying to understand from the inside out what the process is like and what recovery is like. So I encourage people to visit the website and check out our . . . we've got the largest collection of young people speaker tapes that you can download and listen to.Helping Others Live Sober