Tag: Treatment

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Adolescence Cognitive Behavioral Therapy (CBT) Dialectical Behavioral Therapy (DBT) Mental Health Recovery Spirituality Therapy Treatment

Recovery: Redefining Normal

(Photo credit: Wikipedia)

Stepping onto a path of recovery and beginning the removal of toxicity from one’s life is an arduous, often painful, but beautiful process. But I like to believe that some of our greatest lessons come from our difficulties. Those are the times that provide us with the most insight into what is actually going on with us. Take for instance your relationships with others. Is there a pattern? Have you continued to add links to an unhealthy chain be it consciously or subconsciously? Are you happy?

When there is a history of toxicity in one’s life, particularly when it’s introduced at an early age, what is considered “normal” tends to become skewed. For example, someone raised in a home with an abusive parent may inadvertently seek out relationships with similar personality types. This isn’t a conscious act but rather a direct result of being taught how to be in this world through violence (emotional, physical, visual, etc.). It feels familiar and therefore “normal” to be around toxicity. The question is, how do you break the chain? How do you make new, better choices that are healthy and nurturing?  How do you place yourself in environments that celebrate you for who you are instead of those that persistently denigrate you?

The 12 steps are a brilliant start. They allow us to begin the process of unpeeling the layers of the onion by asking us to turn our eyes inward and check out what’s going on in our minds and in our hearts. That oft-dreaded fourth step tends to help identify a pattern, particularly if we are honest with ourselves when we write it.  Personally, I’ve always liked that process because it feels like I’m stripping the layers of emotional dirt off of me. It’s uncomfortable, but it’s worth it. Frankly, it hurts like hell to look at ourselves and at our lives with a magnifying glass, but dang it, it’s liberating. You just don’t need to carry that stuff around anymore. Twelve-step work is just the start. If it were only that easy, right?

Taking a clinical approach is incredibly beneficial, especially when dealing with trauma, addiction, and mental-health issues.  Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT), to name a few, are invaluable tools to help identify the psychological triggers and hooks we have embedded within us.

But you know what really seals the deal for me? Creating space for Spirituality. I can’t emphasize enough how invaluable it is to develop a spiritual practice. It is the very thing that will feed your soul. No, I’m not selling you religion or a canon of idealized thought. I am, however, urging you to find the calm in your breath, the grounding notion of having your feet planted to the earth, and the healing weight of your hand on your heart. You can break the chain of abuse. You can shut out the tapes that play in your mind, telling you you’re a piece of crap, a failure, not enough, stupid, fat, ugly, useless. You can take your power back. It takes work, but it’s worth all the sweat and tears. Trust me. Be patient. Understand that this process of recovery takes time. Nothing and no one is perfect.

I’ll leave you with this. I was involved in a series of abusive relationships growing up. I was doing the same thing, expecting different results. I eventually discovered I was continuing the pattern of emotional denigration established in my childhood and nurtured in my adolescence. When I finally smashed through that chain several years into my recovery and only after working tirelessly with a therapist, meditation, yoga, 12 steps, I was free. This doesn’t mean the trauma or triggers went away. It means I finally learned to identify them, and have garnered tools to help me respond to them differently. When I met my husband, I quickly discovered he was different. For one thing, he showed me unconditional support, which I hesitated to believe was true. It took me almost two years to accept the fact that I had, in fact, broken that chain and was capable of having relationships that were built on trust and respect. I realized I could believe someone; something this traumatized gal was never able to do. This was proof that I had redefined my “normal” and surrounded myself with a healthy, loving new family. In fact, I redefined my response to the world and its triggers, not just within my family, but also in my life. Ultimately, I took my power back. You can too.  You just have to do the work!

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.

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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
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

 

Categories
Alcoholism Mental Health Recovery Treatment

Wet House, Wet Drunk

What do they do with the hopeless, late-stage alcoholics in Minnesota? They sometimes send them to the St. Anthony Residence, which is one of five “wet-houses” in the Twin Cities area. Wet houses are residential facilities where sobriety and recovery aren’t expected. They use a “harm-reduction” model, which employs a set of strategies meant to reduce the negative effects of alcohol (homelessness, panhandling, jail, etc.). These wet houses also provide shelter, meals, and medical attention for late-stage alcoholics. Often, their modality of thought is, “It’s safer and cheaper to have these guys drinking in a controlled environment than out on the cold Minnesota streets.”  And expense certainly does motivate:  Rather than the state spending inordinate amounts of money on jails, detox, et cetera, they now share the $18,000 per year costs for room and board with Catholic Charities. Residents receive $89 a month for expenses (most of which is spent on alcohol). This is a clear savings for the state. In fact, research done regarding a similar program in Seattle and published in the American Medical Association in 2009, showed striking savings in their public spending:

“The year prior to the opening of the wet house, its 95 participants had cost the government nearly $8.2 million in policing, jail, detox and other medical spending, an average of $4,066 per person per month. But after moving into the wet house, costs were reduced to $1,492 per person monthly after six months, and to $958 after 12 months.”

Still, according to Bill Hockenberger, a recovering alcoholic who manages St. Anthony’s, three to five percent of the residents stop drinking. But I wonder if cost is really a good reason to give up on the 12-step model that has been clearly shown to work.

As I watched these interviews with some of these men today, I was struck by the textbook depiction of their addiction to alcohol. Deluded into thinking that all they’ll ever be is an alcoholic, they’ve literally thrown in the towel and succumbed to the disease. One resident says, “There’s no hope for a scoundrel like me.” Their descriptions of drinking and their corresponding alcoholism mirror the way it’s described in the “Doctor’s Opinion”: “The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one.” Many of these men were homeless and had been in and out of detox facilities and treatment centers–all resulting in relapse. Their “failure” at sobriety ultimately led them to their residency in a wet-house either via county recommendation or by a self-appointed application. Residing in a wet house may mean retaining the last shred of one’s dignity, and it also may represent the end of the line for the hopeless and often-times dying: the “unfortunates” as the Big Book describes them, those “constitutionally incapable of being honest with themselves.”

St. Anthony’s takes men who would otherwise be homeless and panhandling and provides them with a safe place to lay their heads…and to drink. Perhaps placing an active, low-bottom drunk in an environment which actively shows them what drinking does will bring about an awareness of the disease. There are certainly those who stay in these wet houses and choose not to drink. In fact, some even get sober and leave, though I believe those to be in the minority. Even though counseling is made available, and drinking is only allowed in one area, I’m just not convinced that sobriety is attainable when recovery is looked upon with such complacency.  Just because the alcoholic is hopeless doesn’t mean we have to become hopeless in our approach.

Related articles:

A safe place to drink, or just giving up? (cnn.com)

You Are Here: The ‘Wet House’ Where Alcoholics Can Keep Drinking (nytimes.com)

At St. Paul ‘wet house,’ liquor can be their life – and death (twincities.com)

‘Wet Houses’: Letting Alcoholics Drink, with Surprising Results (healthland.time.com)

 

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