The road to help is paved with good intentions.

Recently I've received a lot of messages (pro and con) regarding my response under A Postcard From The Edge.

I violated one of my own rules, listed under my homenode, when I wrote that piece. Too much use of "I, me, mine."

My feeble excuse for relating my own experiences (and to some noders, taking the focus off of our good friend and placing it upon myself) is this: there are few better ways to help folks in trouble than to relate one's own experience with the same troubles, and conclude with how one got out of such troubles.

When I received a couple of messages from our fellow noder, they were quite re-assuring. He also told me that he didn't like the fact that I criticized him for writing, when his time would best be spent seeking out shelter and help. For that, I apologize publicly. Those words were a bit too strong. Nothing, but for a good cry, is as cathartic as writing.

Now for a source of controversy, I'm sure. He told me that he'd indeed found a shelter and had been referred to several A.A. meetings. I am not a critic of A.A. in general, and believe that hundreds of thousands; perhaps millions, have been helped by A.A. and other 12-step programs. However, there tends to be a conventional wisdom that endures, even after the emergence of a public awareness of depression and bipolar disorders, for example. The conventional wisdom is, "find a troubled person reeking of alcohol and get him to A.A. - that'll work."

This is a daylog so I've not researched the evolution of rehab centers. Anecdotal experience with them reveals that their success rate, as medical institutions go, is horribly poor. The same goes for A.A., whose members admit that about one member in 16 stays sober; the rest fall by the wayside. The A.A.s believe that those 15 who leave their ranks end up in prison, in an insane asylum, or dead - so says the "Big Book," the text for Alcoholics Anonymous.

Is alcoholism the cause or the symptom?

I belong to a therapy group for bipolar disorder sufferers. Of the handful of us, two are regular A.A. members. The rest of us generally agree that mixing alcohol and our myriad anti-depressants, anti-psychotics and sedatives is not indicated and not a good thing. The thing that we all have in common is prior to the realization that we had a psychiatric disorder, we were abusing some sort of substance (alcohol, food, cocaine, sex). These addictions and the cravings associated with them faded as we began to recover from our root illness.

Few depressed, bipolar or otherwise mentally ill people have the luxury of weekly therapy. Health insurance programs of all types have succeeded in reducing benefits for "psychiatric" coverage to little or nothing.

It's all the rage these days for the family and friends of alcoholics and drug addicts to dial the number of a rehab center, and then, under the supervision of an M.S.W., have an intervention, after which the substance-abuser is packed up and shipped off to rehab. This may be all well and good. But I propose a different kind of intervention.

Perhaps an M.D., with a specialty in psychiatry, should be the one to conduct the intervention, gather history, and analyze the patient from a psychiatric point of view. It was only after that happened to me that I began to heal, thrive, and learn to live with my condition.

We all know that but for a few people with rich insurance plans, such an intervention is not feasible. Additionally, so long as the vast majority of substance-abuse treatment specialists and personnel cling steadfastly to the 12-step model of recovery, such an intervention will not evolve any time soon.

Perhaps this will be fodder for our bipolars group?