Month: July 2011

Categories
Recovery Spirituality

The Adolescent Brain Meets Tradition

Image by HaPe_Gera via Flickr
Recovery means more than just eliminating drugs and alcohol. It also means discovering new ways to cope with the feelings you were running from when you used. Troubled home life? Run. Problems at school? Run. I’m not talking about literally running, either; I’m talking about cloaking the feelings of loss and abandonment in the toxic blanket of drugs and alcohol in an attempt to mute the pain. As human beings, we need to be nurtured, loved, supported and fed, and we naturally assume we will get all of this from our parents. Sometimes, we don’t, and when that happens, we end up attempting to regulate our wavering emotions via unhealthy means. Typically, it’s the misuse of food, sex, obsessive behavior, porn, video games, and drugs and alcohol acting as the bill of fare. When these are the only tools we have in terms of managing our difficulties, the truth of what we’re running from remains untouched. Through the 12 steps, therapy, meditation, and spiritual practice, we are presented with various ways in which we can cope with tough feelings. Not every avenue of exploration will fit, but the more options we have, the better!
I recently ran across an interesting article in Counselor Magazine, talking about teens’ ability to relate socially and emotionally in the typical AA meeting and how their cognitive development may not allow them to truly grasp the spiritual aspect of the program. While adults are more settled in the possibility of a spiritual ideology, adolescents are more or less in the highly developmental stage of questioning the existence of God and realistic nature of spirituality itself. Also noted in this article is the difficulty teens may have relating to their fellow alcoholics due to the broad difference in age, which is an average of 48, according to aa.org.

So, how can we help teens gain a better grasp on a spiritual path when the exact nature of their development is such that this understanding is still in evolvingt? How can we address the need to ask for help and encourage the necessity to rely on others when developmentally, the tendency is to believe in self-reliance?  Young people’s AA is a great beginning, as it allows for teens to find some common ground in recovery, providing a regular group of like-minded people seeking a similar solution.  Still, it isn’t the only solution. Adolescence is a time when the religious traditions normative in early childhood are becoming questionable. Part of this is the natural, developmental proclivity toward being anti-authority and of course being inherently rebellious. Part of it is the curious, often exotic thought processes which are part and parcel to their emotional development.  If we address recovery with rigidity: “you must believe/submit” rather than encourage the broader concept of “your own understanding,” we risk alienation and ultimately steer teens away from recovery. Instead, encouraging discovery of their own beliefs and supporting their curiosity for meditation, Eastern practices, or any other place where their personal search might take them is highly beneficial.
Remember, you were a teen once too!
Categories
Addiction Alcoholism

Amy Winehouse Grasps Addiction’s Fateful Hand

Cover of Amy Winehouse

The death of Amy Winehouse, mere months after another misfired attempt at rehab leaves
me thinking more and more about the misleading notion of a revolving door in recovery. I am reminded of the perceived invincibility we tend to have when we’re using and how deadly that assumption can be. Unfortunately, we’ve been subjected to inadvertent voyeurism as we’ve fallen witness to Winehouse’s public demise.

As part of a recovery community, we can certainly sit and proselytize about the myriad things she could have or should have done differently, but the fact remains: she was an addict, and her addiction ultimately won this round.  Self-loathing, lack of self-worth, and self-sabotage are all symptomatic traits of addiction; Amy Winehouse expressed hers soulfully in her music, and I can’t begin to imagine the driving, internal heartache, which led her to continue on such a fatal path.

I worry that the hype around her death will somehow take the focus off of addiction or worse yet, romanticize the life and death of an extremely talented, yet deeply suffering young woman.  It’s sad that we’ve lost another addict, but sadder still that it’s not surprising. The fact is, fame, talent and genius don’t make us invincible, nor do those qualities place us in an elite, protective capsule. Addiction doesn’t care. It never has and it never will.

While addiction is a treatable disease, it will always remain one that requires willingness on the addicts’ part. Without that, we risk ending up with dust in our eyes. Truth be told, I’m deeply saddened by the loss of Amy; not so much because she was a gifted artist with a broad future ahead of her, but because she could have been any one of us. She could have been a loved one; she could have been you; she could have been me.

Related articles
Categories
Mental Health Mindfulness

Mindfulness: Looking at Addiction In a New Way

The benefits of a mindfulness practice can be felt by anyone willing to be present and prepared to stop running from their feelings and fears. The practice of mindfulness allows us to come into direct contact with the here and now, bringing with it a sense of awareness and healing. In doing so, we are able to directly see how our addictions, actions, and behaviors are causing us suffering.  Similar to the 12-step model, mindfulness provides us with the opportunity to take contrary action. As a result, we begin to notice and work with our uncomfortable thoughts, feelings, body sensations, and reactions to the physical and emotional cravings closely associated with addiction.

Image via Wikipedia

Confronted with anxiety or fear or panic, our basic, human instinct is to run in the opposite direction as quickly as possible, hoping to get out of harm’s way. These feelings are uninvited guests, after all, right?  In this case, our bodies’ “fight or flight” response is immediately triggered. So, what happens if we go the other way? What happens if we turn into our fear, into our anxiety, or into our trauma? What if, through conscious breath and direct attention, we learn to give those feelings space? The interesting thing about doing this is the intensity of those feelings will eventually begin to lesson and our unwanted guests start to lose their footing. No, the trauma isn’t gone, but in that moment of stopping and facing our fears, we have done something incredibly powerful: shone light into the darkest corners of our hearts and minds.

Through my own experience in recovery, dealing with trauma and its corresponding anxiety, I have found the most peace and healing through my practice of meditation and yoga. I have learned to use my breath in a way that allows me to move with my emotions rather against them. I liken it to moving with the ebb and flow of the sea. In early sobriety, when a higher power was in question, I remember being told to “try and stop a wave” only to discover that I most certainly could not. Within that phrase also lies an inference that we cannot “stop” something from coming at us. Utilizing mindfulness, we then learn how to to ride the wave without causing additional harm and without getting lost in the energy driving the fear or addiction. In turn, we may discover that those blasted shadows we are accustomed to running from appear much larger than their reflecting counterpart. From this perspective, things look a heck of a lot more manageable.

As we are challenged to turn off the autopilot we’ve become accustomed to, we are given an opportunity to learn to respond to triggers and cravings in a non-harming way. As such, we are beginning to view our feelings, thoughts, cravings, and sensations with curiosity and non-judgment rather that the usual disdain. In those moments when the freedom of awareness and being present are there, the real healing has a chance to begin: one breath at a time.

Elisha Goldstein, Ph.D. has a wonderful series, which I’ve linked to below:

Mindfulness and Addiction, Part 1

Mindfulness and Addiction, Part 2

Mindfulness and Addiction, Part 3

Further reading:
Meditation for Addiction Recovery

Kevin Griffin

Mindfulness and Addiction meetings:
Against the Stream

Categories
Dialectical Behavioral Therapy (DBT)

DBT, Mental Health & Addiction

Sometimes someone comes into contact with treatment because their drug use got out of control only to discover their problem isn’t actually addiction, but rather, an untreated mental health issue. Often times the misuse of drugs and alcohol is an ardent attempt to quell the feelings of anxiety or lift the fog of depression. Sometimes it’s a way to disengage from the flashbacks of trauma. Sometimes it’s a way to close the door on a panic attack. However, many times, these modes of self-treatment go too far, and the claws of addiction sink in, creating another layer to uncover and treat. Still, once the addiction piece of the puzzle is treated, therein lies the deeper, more complicated issue of mental illness. What then?

At Visions, we have embraced the mental health component of treatment and are adding a mental health track to our existing treatment plan. We are utilizing a wider range of treatment methodologies and branching into the area of Dialectical Behavioral Training (DBT). DBT is a “comprehensive cognitive behavioral treatment developed by Marsha M. Linehan over the last 25 years,”[i] and has primarily been used to treat patients struggling with suicidal ideation, suicide attempts, a desire to self-harm, and self-mutilation. After discovering numerous problems with the traditional use of cognitive behavioral therapy (CBT) in treating this particular clientele, Linehan began to integrate validation strategies (also known as acceptance-based interventions) into her treatment methodology.  By integrating these validation strategies, Linehan inevitably began empowering her clientele and creating an environment of acceptance, while also encouraging them to begin to recognize the need to consciously change negative behaviors. DBT has also become one of the more successful treatments for patients suffering from borderline personality disorder (BPD), a group typically resistant to the traditional use of CBT.

To illustrate some of the problems Marsha Linehan and her team encountered, here are the three issues they found to be the most troublesome with traditional CBT:

  1. Clients receiving CBT found the unrelenting focus on change inherent to CBT invalidating. Clients responded by withdrawing from treatment, by becoming angry, or by vacillating between the two. This resulted in a high drop out rate. And, obviously, if clients do not attend treatment, they cannot benefit from treatment.
  2. Clients unintentionally positively reinforced their therapists for ineffective treatment while punishing their therapists for effective therapy. In other words, therapists were unwittingly under the control of consequences outside their awareness, just as all humans are. For example, the research team noticed through its review of audio taped sessions that therapists would “back off” pushing for change of behavior when the client’s response was one of anger, or emotional withdrawal, or shame, or threatened self-harm. Similarly, clients would reward the therapist with interpersonal warmth or engagement if the therapist allowed them to change the topic of the session from one they didn’t want to discuss to one they did want to discuss.
  3. The sheer volume and severity of problems presented by clients made it impossible to use the standard CBT format. Individual therapists simply did not have time to both address the problems presented by clients – suicide attempts, urges to self-harm, urges to quit treatment, noncompliance with homework assignments, untreated depression, anxiety disorders, etc, AND have session time devoted to helping the client learn and apply more adaptive skills.[ii]

In addition to utilizing validation strategies, DBT also employs the use of mindfulness as one of the core concepts behind this therapy. Mindfulness is beneficial in the treatment of addiction and mental illness: it introduces the concept of non-judgmental observation, where we can observe our own actions and behaviors without criticism; Being mindful requires that we are engaged in present-time awareness: the here and now. This is where mindfulness is truly invaluable. If we are aware of our actions in the here and now, we are less likely to get caught in the destructive patterns of “what if? and “remember when?” In the practice of meditation, the act of “coming back to the breath” helps one stay in the present. Learning how to label emotions and feelings that may present themselves can help sufferers from getting lost in negative thought patterns. For example, if we are feeling scared or triggered, paranoid or angry, naming that emotion with non-judgmental observation will help us retain our present-time awareness.

In time, hopefully, the implementation of treatments such as DBT and mindfulness will help provide sufferers with some valuable tools for regulating emotion, distress tolerance and managing interpersonal relationships.

[ii] https://behavioraltech.org/resources/whatisdbt.cfm
For more detailed information on DBT, please visit these sites:
Washington University
Behavioral Tech
Wikipedia
 
Categories
Addiction Smoking

Can Graphic Imagery Deter Smokers?

Who actually smokes anymore? I find myself saying this every time I see someone light up; especially after all we’ve learned. It’s not like there’s some beneficial properties to smoking chemically treated tobacco!

Anti-smoking laws have been on the rise for years. Truth is, being a smoker is expensive and isolating, not to mention bad for your health. Looks like the ultimate goal is to eliminate smoking in public places once and for all. It used to be that folks could smoke in restaurants or planes, negatively impacting the communal air space. Over time this has changed. As a former smoker, I remember feeling the heat when those first changes were initiated. I remember being resentful and feeling as though my rights were being violated.  My young, feisty attitude screamed, “I can do whatever I want!” and of course, I smoked anyway. I realize now that it wasn’t my “right” to harm those around me. That self-righteousness was really the selfishness of my addiction talking. True to addict form, all I could think about was my next cigarette.

Recently, the FDA released 9 graphic anti-smoking images that are required to be placed on the top half of cigarette packaging by the Fall of 2012. At the same time, Australia will begin enforcing a ban on brand labels on cigarette packaging in an effort to lesson the intrigue and coolness factor associated with smoking. Despite the usual grumblings from the tobacco industry, the FDA is holding firm. Sadly, the graphic images haven’t really impacted the way people are smoking, though. According to a new, German study, smokers that have been deprived of nicotine for short periods of time have a lower response to fear.  “In those who stop smoking, the activity of the fear center has been lowered so much that they are not very receptive to the scary photos,” said study researcher René Hurlemann, of the University of Bonn in Germany.  They came to this conclusion after scanning the brains of 28 smokers and 28 non-smokers using functional magnetic resonance imaging (fMRI)[1].  And researcher Özgür Onur of the University of Köln noted that smokers, particularly after a 12-hour abstinence, were “indifferent to fear.” Onur went on to say, “It seems that they (smokers) are mentally caught up in their addiction, resulting in a lowered receptivity for fear-inducing stimuli.” That’s a problem, particularly when fear is our body’s natural way of keeping us from doing something perilous. 

While the FDA’s imagery may be useful in deterring non-smokers from picking up in the first place, I hesitate to think that it will greatly change the way current smokers look at their legal drug of choice. The teens I come across certainly aren’t deterred. If anything, they are viewing the graphic images as a joke.

Beyond the current results of these scientific studies, the taste left in my mouth is really one of denial seasoned with a nicotine chaser.


[1] https://www.myhealthnewsdaily.com/smokers-brain-fear-center-graphic-cigarette-labels-1693/
Related articles

Image courtesy of the FDA

Categories
Parenting Sexuality

New Study, Old Issues

Image via Wikipedia

Recent data from a new government report documenting the welfare of children shows a drop in teen births going from “21.7 births per 1000 girls in 2008 to 20.1 per 1000 in 2009.” Other aspects of the report weren’t as positive: the number of eighth-graders who’ve used illicit drugs has risen; more children are living in poverty; fewer children are likely to live with at least one parent who is working full time. The report was compiled by the Federal Interagency Forum on Child and Family Statistics, a “working group of 22 federal agencies that collect, analyze, and convey data on issues pertaining to children birth to 18 and their families.” The study is notably multidimensional, as it covers everything from teen pregnancy and drug use, to obesity, math scores, and poverty.

Still, this study doesn’t provide us with any answers in terms of how to continue to encourage the decline in teen births, or even how to decrease the rising numbers of illicit drug use. It is, however, a great marker for us to refer to as we continue on our parenting journey.  The crux of the matter is we still need to broach the thorny subject of sex, pregnancy, drugs, et cetera, with our kids. We need to talk about the uncomfortable issues before the theory of pregnancy or drug addiction becomes reality.
Talking about the birds and the bees includes more than just the covering the technical side of how babies are made. As much as we may be concerned about the outcome of unfettered sexual activity, there are still runaway emotions occurring simply because of a teen’s developmental status. Fortunately (and unfortunately), we live in a time where conversation triggers are everywhere: films like Juno, or Saved, and television shows like 16 and Pregnant or Teen Mom are certainly fodder for beginning this conversation. Just talk about it; take away the mystery. When that’s gone, the intrigue just may begin to wane as well. Think about it: When you were a kid, and someone implicitly told you not to do something or touch something, was your curiosity piqued? I know mine was.

This conversation is important and ongoing! If we begin to broach the subjectt early on and with as much candor as is age appropriate, we gain the potentiality for honest communication with our kids. Knowing that you can trust your parents and talk to them about the “big” stuff is important—in essence, try to be the one your kids come to rather than the one they hide things from! At the end of the day, it’s far better if this information comes from us as parents than the misanthropic, older kid your child might admire!

Some helpful links to refer to:

New Govt Report On Child Welfare Presents Mixed Picture

Report: Teen Births Drop, Middle-School Drug Use Up

LA Times

How to Talk to Your Children About Sex

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