Category: Recovery

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Addiction Alcoholism Anxiety Mental Health PTSD Recovery

Addressing Recovery and Trauma

Image by Southworth Sailor via Flickr

A history of sexual violence can create an ideal environment for a variety of mental-health issues, addiction, and alcoholism. Often, the triggering event or events are hidden in the annals of one’s mind and perceived as shameful, deep, dark secrets too horrible to share…with anyone. As a result, drugs, alcohol, and risk-taking behaviors are often seen as the primary issue when one enters treatment. Time and again, we see that this isn’t always the case; That becomes clear when we look at it in terms of statistics:

  • One out of every 6 American women has been the victim of an attempted or completed rape in her lifetime (14.8% completed rape; 2.8% attempted rape)[1];
  • 29% are age 12-17;
  • 44% are under age 18;
  • 80% are under age 30.; 12-34 are the highest risk years.
  • Girls ages 16-19 are 4 times more likely than the general population to be victims of rape, attempted rape, or sexual assault;
  • 7% if girls in grades 5-8 (approx. ages 10-13) and 12% of girls in grades 9-12 (approx. ages 14-17) said they had been sexually abused;
  • 3% of boys grades 5-8 and 5% of boys in grades 9-12 said they have been sexually abused[2].

As I frequently tweet Intervention, one of the things I notice on a regular basis is the consistency in which the women on the show are frequently struggling with a history of sexual violence, and are using drugs, alcohol, and promiscuity as their  primary coping skill. From the outside looking in, it’s clear that the goal is to try to desensitize and anesthetize feelings of shame and guilt, et cetera; in other words, do anything and everything NOT to feel, remember, re-experience, or suffer from the emotional attachment to the event itself.

Twelve-step programs were written with specific goals in mind: to stop the alcoholic/addict from drinking and using. The steps work well in that regard, mostly because they are based on the disease model, addressing issues of alcoholism and addiction accordingly. However, the same tools provided to address addiction issues don’t always work in concert with mental-health issues, particularly those attached to sexual violence. We know the steps adequately provide an alcoholic/addict with the necessary skills needed to learn to take responsibility for and subsequently change their negative behaviors. They do so by asking the addict/alcoholic to take responsibility for their actions, face their fears, and acknowledge that they took part in creating their own demise. However, being sexually abused or raped isn’t a negative behavior to be changed but rather a causative, biting factor in things like:

  • Depression
  • Post-Traumatic Stress Disorder (PTSD)
  • Alcohol and Drug Abuse
  • Suicidal Ideation
  • Eating Disorders

What then, do we do from a recovery standpoint when the predominant disease model isn’t geared to address issues of this caliber? The Big Book, the 12-step primer, was written by men addressing men’s issues, in a time when women were typically viewed as the ones affected by their spouse’s alcoholism and not as the alcoholics themselves. As more women began to come forward as alcoholics and addicts, the tools didn’t always adapt to the new issues that arose because of gender disparity, but rather, they stayed the same, assuming a one-size-fits-all mentality.  In the cases of women dealing with sexual violence, being asked to take responsibility for an abuse event has the potentiality to create more or actually deepen the existing trauma, particularly if the innate issues of shame and guilt associated with it are ignored. The reality is, being victimized by sexual violence is not the fault of the victim. What does need to be addressed, however, is the anger, self-victimization, and negative behavioral byproducts occurring as a result.

We clearly have a multi-layered healing process on our hands, so first, the negative coping skills must be eliminated: Sobriety is an obvious first step and necessary component to support the healing process. Additionally, working with meditation and mind-body awareness techniques are also useful in helping one manage their anxiety, negative feelings toward oneself, and in re-building self-esteem. A therapist skilled in treating PTSD and this sort of trauma is also important, particularly since this is often a lifelong process.

It is in forgiving ourselves that we have the ability to become free.


[1] National Institute of Justice & Centers for Disease Control & Prevention. Prevalence, Incidence and Consequences of Violence Against Women Survey. 1998.
[2] 1998 Commonwealth Fund Survey of the Health of Adolescent Girls. 1998

Sources and support:
RAINN
One in Four
National Coalition Against Domestic Violence

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Mental Health Recovery

Fight or Flight: When the Anxiety Wheel Spins

Image by jpmatth via Flickr
Why are our kids so stressed out? Is it the pressures of school and peer relations or is there something else going on? Sure, stress is a naturally occurring phenomena that can help and/or hinder someone, depending upon the situation. There are surely instances where the slight adrenaline rush of stress can actually prove beneficial, but when it’s constant and unyielding, stress can be overwhelming. The body’s natural fight or flight response occurs when stress is introduced, allowing us to ready ourselves for “battle,” so to speak. That “battle” can be an exam at school or even a mild confrontation on the school yard, but it’s usually temporary. “Fight or flight” is a term used to describe the body’s natural physiological response to stress. The Genetic Science Learning Center at the University of Utah has a wonderful example (see it here) showing the physiological changes that occur!

The qualities of the fight or flight response include:
  • Increased heart rate
  • Faster intakes of breath
  • Enlarged pupils
  • The digestive system slows
As I noted, these particular physical changes occur naturally when the fight or flight response is triggered. In small doses, it’s appropriate and helpful, but as with anything, remaining in the a state of fight or flight for a long period of time can create untenable stress as the body and mind begin to work against itself. You know unpleasant but often typically temporary feeling of having “butterflies in the belly”? Well, imagine it lingering for a long time: It would become more and more difficult to ignore.

Some kids, and perhaps these are the one’s enduring sustained periods of stress, the fight or flight phenomenon happens without warning, and without a clearly identified trigger fueling the body’s response. For these kids, the sense of deep worry and impending doom are a prevalent and may often seem unwarranted. This is anxiety, and with it comes:
  • Tightness in the chest
  • Stomachache
  • Dizziness
  • Dread
  • Worry
Anxiety can have a genetic component, for example, mom or dad, grandma or grandpa, et cetera, may suffer from anxiety. Anxiety can also occur after an extremely stressful event: childhood trauma, divorce, loss, a car accident. Some kids are clearly more sensitive than others and may very well react intensely to something another child can walk away from. Rather than shaming them about their reactivity, we need to offer them solace. These kids need as much support as possible, not only from parents, but from clinicians trained to help sufferers manage their anxiety. It takes time, dedication and hard work, but in time, one will have many healthy tools to choose from, hopefully avoiding the dead-end path to addiction. 
Articles used as reference and for more information:
Kidshealth: FearKidshealth: StressYour Child and Anxiety (WebMD)
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Recovery

Back to School: Let’s Get This Party Started!

School has started, though the remnants of the Summer heat are still lingering about. It’s also prime time for the first of many anticipated school parties! For the newly sober, and even for those with a little time under their belts, this might be a source of contention or stress. So, how DO you participate while staying safe and sober?
For starters:
  • Bring a friend with you that has your best interests in mind. In other words, someone who isn’t on the fence about you being clean and sober! 
  • Arrange for your own transportation so you don’t have to rely on someone else if you want to make a quick exit. 
  • Have a plan, and give yourself an out so you don’t get stuck in a bad situation.
  • Call your sponsor and let your sober network know what you’re doing: Share your plan!
  • Communicate with your parents and let them know what’s going on.
  • Concerned there won’t be any non-alcoholic beverages? Bring your own! 
The trouble with school parties is, often times they’re organized with this idea that getting wasted is the end goal (I’m reminded of Superbad here, despite it’s over-the-top depiction of adolescence!). If a school party falls into your weekend plans, go with a good head on your shoulders and a positive plan of action. Walking a sober path is a learned skill, but it’s not impossible. It takes time to develop positive patterns of behavior while still maintaining our social status amongst our peers. Sometimes, it’s a matter of educating those around us; sometimes it’s about walking away and starting anew.

Sobriety will teach you that fun doesn’t have to include a blackout and a night praying to the porcelain God. Nor does it have to include glib confirmations of the night’s events from friends the next day. Eventually, taking responsibility for your actions will be the de rigueur choice rather than fighting to maintain an old ideal. At some point, you might even discover that you are pretty darn fun all on your own, even whilst pumped up on silliness with a water chaser. 
Categories
Education Recovery

School: Getting Back in the Groove

Cover via Amazon
Even without addiction issues, going back to school can be a bear. Going from middle school to high school is a huge shift, but more often than not, you’re not away from home. However, the shift from high school to college can be huge, especially if going to college means living on your own. All of a sudden the safety of any parental input (no matter how annoying it may be) is gone–trust me when I say this, you’ll eventually miss the family dinners you fought so hard to get out of.
There are a few things to keep in mind when going back to school, particularly when most schools and colleges are starting and our nerves are shaking. If we’re newly sober, then the heat is really on, particularly when we’re going back to our old stomping grounds.
  • Stay connected with your sponsor and others in sobriety. 
  • Set firm boundaries with old friends that may be weary of the new you. If they want you to “hang out” like you used to before you “went away,” say no. Real friends won’t try to drag you down. 
  • Maintain open communication, not only with your sponsor and friends, but with your parents and therapists as well. Recovery is a net: if you weave a wide enough web, you are more apt to create an environment of emotional and physical safety. 
  • Develop a healthy exercise program. Sometimes, a good run or a long bike ride can clear a muddled mind. This is a great area to create a buddy system. If you don’t do it one day, you didn’t fail! 
  • Make realistic goals. You don’t have to do everything at once. 
  • Remember to be kind to your body: just because you’re sober doesn’t mean you can start poisoning your system with junk food. 
  • HALT: never get too Hungry, Angry, Lonely, Tired 
  • Show up no matter what. You’re not only showing up for others, you’re showing up for yourself and your sobriety.
The reality is, school can be frightening: the newness, the change, and the idea of venturing into the unknown. Taking things one breathe at a time is key to survival. Sleep is your friend, cry if you need to, and ask for help. Everything is going to be okay!Resources:
Angels at Risk
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Addiction Alcoholism Recovery

Becoming a Stag-A-Holic in Recovery

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Recovery needs to be safe. It needs to be a place where we can shed our layers of fear and self-loathing and learn to be good enough as we are. It needs not to be the predatory place it’s become, where young girls learning to navigate a sober path to recovery end up falling prey to older men acting out their rescue fantasies (or worse). The notion of the 13th step (the unwritten yet prevalent practice of someone with longer sobriety praying on the vulnerability of the newcomer of the opposite sex) is alive and well, making for high levels of emotional risk for those coming in, particularly when one shares something deeply personal from the podium at a mixed meeting.

When I got sober, I was a 21-year-old maniac. The concept of boundaries were foreign to me, and I was often known to place myself in unsafe situations—an unfortunate by-product of my previously self-depleting, self-deprecating life prior to recovery. But I got lucky. I had an Eskimo, who acted as my big brother, scooping me up under his wing and holding the predators at bay. I wasn’t protected forever, though. I still managed to get myself into incredible trouble, acting out left and right, because I hadn’t yet learned how to use to the tools of recovery. I hadn’t learned how to create and maintain boundaries. I hadn’t learned that emotional and physical safety was necessary for me to heal and get sober. It didn’t take long for me to discovery that these were the things that I needed to learn from the women in the rooms. Big brother or not, some things just don’t go over well.

It takes time to learn the value of sharing in a general way. New, we’re raw and often unedited. Add adolescence to the mix, and being unedited is par for the course especially with the innate desire to fit in, the need to individuate, and the added weight of navigating a path in recovery. Yes, there are a bevy of young people’s meetings, where the majority of the attendees are more relatable. What seems to be missing, however, is a wide variety of young people’s stag meetings. It’s too bad, because those are the meetings where you can share more candidly and without invariably placing yourself at risk.

So, what does one do when your world is crumbling and you need to drop down to your emotional bare bones? You can start by sharing the deeply personal, vulnerable, emotionally dangerous shares for those who have your best interests in mind: your sponsor, your therapist, or a friend close to you that has a solid foundation in recovery. Lean into the gendered sails of those who’ve walked the path before you. Trust me on this: getting sober is the easy part. It’s staying sober and safe that takes work. That’s what stags are there for.

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Recovery Spirituality

The Adolescent Brain Meets Tradition

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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 Recovery Spirituality

AA and Spirituality

The 12-step model is certainly reliable and is the standard go-to place for most people seeking recovery. It’s certainly the model we refer to first in the recovery world. However, there are times when we come across an alcoholic or addict who is deeply atheist and subsequently hits a wall when they get to Step 2: “Came to believe that a Power greater than ourselves can restore us to sanity.” Can AA work for them too? Most people will say that it can. Some will leave things as-is, and some will need to make some minor language changes in order to match their beliefs about spirituality. Unfortunately, there are some folks devoted to retaining the exact language that makes up the steps, so much so they are unwilling to accept even a minor change.

As reported in The Fix, a Toronto group of atheists in recovery has just run into that very thing.  The group was listed in their local AA directory, they had a fairly large batch of regular attendees, and yet, some in the community still found their modifications of the steps to be a threat to AA as a whole. Apparently, the idea of a non-secular recovery group was too much and a controversy broke out. Los Angeles has its share of non-secular meetings, but to my knowledge, there hasn’t been newsworthy controversy thus far and the groups seem to be thriving.

Here’s the thing, the “only requirement for membership is a desire to stop drinking,” right? To me that means regardless of someone’s religious beliefs, gender or sexual orientation, they have a right to be there. When I got sober, I struggled a great deal with the God concept. Still, I was embraced by my fellow alcoholics and encouraged to find whatever worked for me. I managed to retain my viewpoint on the intangible nature of a power greater than myself whilst still developing a deep spiritual practice and strong foundation for my sobriety. The steps are viable tools for recovery for me even if I need to alter a few things. My sobriety hasn’t been negatively impacted as a result. So, why the resistance from some when it comes to change in AA? Isn’t our ultimate goal to achieve sobriety? Isn’t it a goal to untangle the addict mind and redirect it to a healthy, positive, less self-serving path? Aren’t we supposed to learn to reach out and be of service, giving back what has been so freely given to us? Why, then, would we want to close the doors on our fellow alcoholics?

With all the hubbub, I was interested in what literary changes sparked this controversy. The Fix printed two of them:

Step Two: Came to believe that a Power greater than ourselves could restore us to sanity.

Adapted version: Came to accept and to understand that we needed strengths beyond our awareness and resources to restore us to sanity.

Step Three: Made a decision to turn our will and our lives over to the care of God as we understood him.

Adapted version: Made a decision to turn our will and our lives over to the care of the AA program.

Frankly, I don’t see anything wrong with this. Those working this version are still fundamentally going to get to the same place: they will be come to believe that they cannot do this alone; they will use the power of the group to help them recover.
Whether you’re closely tied to a Judeo-Christian belief system or have roots deeply planted on a non-theistic path, recovery IS possible. The 12-step model IS effective. If you need to work the steps with some literary alterations, do so, as long as you work them.

Related articles:

Fight over ‘God’ splits Toronto AA groups (thestar.com)

Categories
Mental Health Parenting Recovery Self-Care Transparency

Father’s Day

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We’re coming up on Father’s Day, and for some, this is a wonderful opportunity to recognize their first hero, their first confidante, or their primary example of “the good guy.” For others, it might mean having to face someone whose trust was lost because of addiction. And for others, it may mean reconciling with the repercussions of not having such an important figure their lives.
I have the pleasure of watching my son and his evolving relationships with his dad and step-dad. I am fortunate to bear witness to their triumphs and struggles, wins and losses, laughter and tears. I understand the inherent value of a healthy, positive father-son relationship, and do all I can do encourage it. 
I was intrigued by this interesting article posted by the Georgia Psychological Association, where Dr. Williams writes about the varying stages of father-son relationships. He says boys often idolize their dads as children, “experience a period of discord” in their teens, begin to evolve as young adults, move into acceptance in their 30s-40s, and eventually “become a legacy of their father’s influence for better and worse” when they reach their 50s and beyond. Seeing my son step onto the path to maturation, I am keenly aware of the need to develop positive habits, some of which need to learned from his father(s). In his case, I am hopeful for a virtuous legacy.
The dynamic between dads and daughters is compelling: Some say girls grow up to marry a version of their dads, while others might carry the nomenclature of “Daddy’s Little Girl” well into their adulthood. There are those, too, who take on the mother figure when mom is absent and dad is left to raise the family on his own. Lastly, there are those whose fathers bailed out, leaving their daughters bereft of a solid, male figurehead. Clearly, things can get complicated. How we manage the complications and find ways to make them palatable is where our recovery work comes in.  As a woman whose relationship with my father is tenuous at best, the tools of my recovery have become invaluable. Learning to let go, learning not to take things personally, learning to remove the ego from the pain of abandonment, and learning to accept that I am sufficient, have become essential. Without these factors, I risk drowning in emotion, a perilous position for any alcoholic/addict.
So, regardless of your relationship with your dad, be it adoring or nebulous, being in recovery gives us the opportunity to develop some kindness and compassion and teaches us how to put it all to good use. (This may actually mean setting a boundary and showing compassion to yourself in some cases!). As we work the steps, we are given the opportunity to change our unskillful behaviors through taking action. After inventories, which require inward reflections, we begin to change our viewpoint and begin taking the appropriate actions toward making positive changes in our relationships with others. It’s the beginning of a lifelong process that teaches us to lesson our expectations, which ultimately increases our ability to accept things as they are.
May this this Father’s Day bring some healing to your hearts and lives. And may you celebrate with an open heart and a compassionate mind,  one breath at a time.
Categories
Addiction Anxiety Depression Mental Health Obsessive-Compulsive Disorder (OCD) PTSD Recovery Therapy Treatment

MDMA: Is This Psychotropic Drug Helpful, Harmful, or Both?

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Last time I wrote about ecstasy, it was about the rise in ER visits and the inherent dangers of using a drug that inevitably depletes one’s levels of serotonin and has the potentiality of long-term brain damage. So, when I came across an article talking about using MDMA (ecstasy) to treat post-traumatic stress syndrome (PTSD), my curiosity was sparked. Psychedelic drugs have been used to treat mental illness before, and with some success: In the 50s and 60s, psychology was in a Freudian phase, viewing psychological issues as conflicts between the conscious and unconscious minds. At that time, psychedelics were used to allow patients to face their unconscious minds while awake, which purportedly eliminated the variables of memory retrieval. Still, these methods of treatment weren’t without controversy.  With the influx of street use, and folks like Timothy Leary telling people to “”Turn on, tune in and drop out,” the use of psychedelia to treat mental illness was met with great discernment and fell to the wayside.

Currently, interest in using MDMA and other psychedelics to treat depression, obsessive-compulsive disorder (OCD) and PTSD is gaining traction. MAPS is doing extended research on this subject, and states that MDMA isn’t the street drug we call ecstasy, noting that while ecstasy contains MDMA, it also may contain ketamine, caffeine, BZP, and other narcotics and stimulants. According the MAPS site they are “undertakinga 10-year, $10 million plan to make MDMA into an FDA-approved prescription medicine.” They are also “currently the only organization in the world funding clinical trials of MDMA-assisted psychotherapy. For-profit pharmaceutical companies are not interested in developing MDMA into a medicine because the patent for MDMA has expired. Companies also cannot profit from MDMA because it is only administered a limited number of times, unlike most medications for mental illnesses which are taken on a daily basis.”

The use of this drug has leaned so far from its psychotherapeutic roots, proving to be one of the most popular, highly sought-after street drugs around. Because of this, the useful aspect of this drug may easily be overlooked, forcing us to question how we can take something that has morphed into a social enigma and call it useful. I’m curious, will sufficient research place this drug at the discerning hands of medical professionals once again? And how do we, as a recovery community accept this when we have kids coming in suffering from the long-term, negative effects caused by this very drug?

Related articles:

MDMA May Help Relieve Posttraumatic Stress Disorder(time.com)

Ecstasy As Treatment for PTSD from Sexual Trauma and War? New Research Shows Very Promising Results (alternet.org)

Clinical Study of MDMA Confirms Benefits Noted by Therapists Before It Was Banned (reason.com)

Neuroscience for Kids

Ecstasy Associated With Chronic Change in Brain Function

 

Categories
Addiction Opiates Recovery Treatment

Saboxone: A Methadone Alternative?

Recovering from opiate addiction is no walk in the park. With something like heroin, symptoms can occur within 12 hours of the last high, causing addicts several days of sheer misery. Some addicts have no other choice but to detox on their own, suffering the miserable consequences of their addiction. In some ways, if they can make it past that second day, they have a good chance for a successful detox.  Some, however, have the opportunity to go to treatment, which provides addicts the benefit of supportive care and medications to ease the pain and discomfort of withdrawal. A common medication used for this is called Suboxone (bupenophine and noloxone) and purportedly shortens the length of the detox while also treating the withdrawal symptoms. It’s also used for long-term maintenance much like methadone has been used in the past, sans the stigmatization. A prescription for Suboxone means you don’t have to stand in a clinic line for your daily dose, but rather, you get your 30-day rx from a physician.

There are three phases to the using Saboxone in opioid addiction therapy. The induction phase, which is a “medically monitored startup” of the medication, begun 12-24 hours after the addict has abstained from opiates and is in the early stages of withdrawal.  This is typically done under observation in the doctor’s office. Next is the stabilization phase, which happens when the patient has “discontinued or greatly reduced” the use of their drug of abuse and is suffering from little to no cravings. Last is the maintenance phase, which culminates in a “medically supervised withdrawal.”

Nothing is ever that simple, though, when it comes to treating addiction.  While Suboxone certainly has its value for assisting with opiate withdrawal and turning people’s lives around, there is a dark side. It is just another opiate after all.  Some addicts will inject it, some will take more than their prescribed dose, if just for a brief bout of euphoria. Suboxone reportedly has a “ceiling effect,” which means it levels off after a certain amount. Additionally, the naloxone component of the drug is supposed to “precipitate withdrawal symptoms” when the drug is injected. Still, the state of Maine has reported some pretty disturbing news events surrounding Saboxone, with reports of the drug being smuggled into prison, hidden behind postal stamps and kids’ coloring pages. Prison smuggling of this drug is widespread, creating problems from New Mexico to Massachusetts.

Despite the reports of abuse and prison smuggling, the use of Saboxone is still proving to be a promising component to treating opiate addiction. Some experts suggest more training for physicians and tighter regulation of the drug in order to address the rate of abuse. This is definitely something the recovery industry will be paying attention to.

Related articles:

Understanding Drug Addiction Withdrawal (everydayhealth.com)

When Children’s Scribbles Hide a Prison Drug

Getting High on Suboxone? The FDA Says It’s Happening

 

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