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Thursday, April 26, 2018

Meditation - The Natural Drug

The research around meditation has become extensive and the scientists are finding more and more reasons why meditation helps the human race. Meditation is no longer the practice of yogi’s, Buddhist monks, and hippies. It has become the one single thing that helps people relax and feel at peace with in. The power of the brain is immense and when it is used to calm and relax an addict it is being used to heal the brain that has been abused by drugs for far too long.

A monk was put into a brain scanner and his brain waves were measured while he meditated. This experiment showed how meditation works on the brain and actually changes the way the brain reacts to stress. There are many such research experiments and neuroscience is coming up with more and more reasons why meditation helps the brain function better every day.

When we think about meditation and recovery we think of how it can help an addict stay sober. Can it help an addict stay sober? I think it can. Addicts use drugs to calm themselves and feel “normal”. Their bodies and minds are addicted to the substance that reduces their anxiety or heightens their awareness. Meditation can do both of these. Meditation has been scientifically proven to reduce anxiety and heighten awareness.

I have used different apps and guided meditations to increase my ability to manage stress and reduce burnout. Taking time away from the stress of my day to breathe and calm my brain helps me to focus on allowing a Higher Power of my understanding to speak to me and guide my thoughts.

Meditation comes in a lot of forms. One of the things I have noticed is that in different times of my own life I have used different forms of meditations and they all have worked to help calm me and ease my stress. When I’m calm and less stressed I can show up for myself, my family, and my clients better.

I have also facilitated a guided meditation by using Tibetan singing bowls with the clients I work with. I have enjoyed watching the new experience make a difference in a person’s life and surprise a person because it helped them feel calm when they didn’t believe it would. Whenever we can use some form of meditation to teach the brain that it can have a positive experience without drugs we are increasing the addicts’ ability to stay clean and sober. We are also teaching the brain that it doesn’t need drugs to feel good. If the brain can be convinced the addict will come along too.

I recommend finding a type of meditation that works for you and giving it a try. There really is no wrong way to introduce personal meditation into your life.

Janet E. Bontrager – Primary Therapist

Thursday, April 19, 2018

Relapse Prevention


Relapse is not a sudden process that happens without warning. Most addicts and alcoholics in recovery that are at risk for relapse experience predictable and progressive warning signs that typically cause so much distress that self-medication with alcohol or drugs seems like the only option. This is often not a conscious process and can happen subtly and slowly over time. These warning signs can develop automatically and unconsciously. Since most recovering individuals have never been taught how to identify and manage relapse warning signs, they don't notice them until the pain becomes too severe to ignore.

Terence T. Gorski is internationally recognized for his contributions to Relapse Prevention Therapy. A renowned cognitive behavioral therapist, Gorski has a wide range of experience and expertise in the chemical dependency field. Through extensive research he has identified specific predictable relapse phases and how to intervene when one recognizes that he or she is on the path toward relapse.
The phases and warning signs of relapse according to Gorski include:

• RETURN OF DENIAL
• AVOIDANCE AND DEFENSIVE BEHAVIOR
• CRISIS BUILDING
• IMMOBILIZATION
• CONFUSION AND OVERREACTION
• DEPRESSION
• BEHAVIORAL LOSS OF CONTROL
• RECOGNITION OF LOSS CONTROL
• THE RELAPSE EPISODE

During the return of denial phase, the addict or alcoholic typically is unable to recognize honestly what he or she is thinking or feeling. This phase leads to avoidance and defensive behavior characterized by the individual not wanting to address anything that may lead to painful or uncomfortable emotions. As a result, he or she begins to avoid people and situations that would challenge an honest look at the self. The individual may become defensive when asked direct questions about wellbeing. Common symptoms include distortions in thinking and the beginnings of compulsive and/or impulsive behaviors. Following a period of denial and avoidance, the individual often finds him or herself building up toward a crisis situation as they begin to experience more and more life problems resulting from extreme denial and avoidance. The individual may begin to experience minor depression and have difficulty seeing realistic solutions to life problems. If left unaddressed this inevitably leads to a phase of immobilization.

During the immobilization stage, the addicted individual becomes incapable of initiating proactive action. They may be going through the motions of day to day living, but they tend to feel helpless to solve problems and may begin to spiral out of control. Thinking becomes clouded and the individual grows increasingly confused and distressed.

An inability to think rationally characterizes the next phase of confusion and overreaction. The dependent individual naturally becomes frustrated with self and others growing increasingly irritable, over reactive, and easily angered. Ultimately, the individual can sink into a depressive phase without proper help and intervention. During the depression phase, the individual may have difficulty managing simple daily routines. Thoughts of suicide, drinking, or drug use begin to arise as a means to cope with the depression. It becomes more and more difficult to ignore or hide the severity of the depression at this point. The dependent person progressively loses the ability to control behavior and regulate emotion.

Once the individual has reached the behavioral loss of control phase, he or she is unable to control behavior and continues to lack awareness of being out of control. Life becomes increasingly chaotic as problems pile up. The individual may stop attending 12 step or treatment meetings or completely reject help altogether at this stage.

Ultimately by the time the individual reaches this stage in the relapse process, their denial erodes and he or she begins to recognize the severity of the problem, how unmanageable life has become, and how little control he or she has at this point. This awareness can be incredibly painful and frightening. By this time, the individual has typically become isolated from his or her support network and may feel as though there is no one to turn to. Self-pity, thoughts of drinking and/or using, dishonesty and manipulation, and a loss of self-confidence characterize this relapse phase.

During the option reduction phase, the person tends to feel trapped and completely incapable of managing his or her life. Drug and alcohol use often seem to be the only options to manage feelings of pain and loneliness. The individual may believe that nothing can help him or her and has typically lost all behavioral control. At this point they have discontinued participation in all treatment and 12 step involvement and may be overwhelmed by resentment, loneliness, and frustration.

Ultimately, these progressive relapse phases result in a relapse episode if left unaddressed. This is when the individual begins to use alcohol or drugs again, usually struggling to regain abstinence. Feelings of shame and guilt characterize this phase when attempts to stop or control use fail. Eventually all control is lost and problems rapidly progress. 

This relapse progression can be summarized in the following way: 

THE RELAPSE SYNDROME

 INTERNAL
--Thought Impairment
--High Stress
--Emotional Impairment
--Sleep Problems
--Memory Problems
--Coordination Problems

EXTERNAL
--Denial Returns
--Crisis Building
--Avoidance and Defensiveness
--Immobilization
--Confusion and Overreaction

 LOSS OF CONTROL
--Depression
--Loss of Behavioral Control
--Recognition of Loss of Control
--Option Reduction

It is important for the dependent individual and loved ones to recognize signs and symptoms of relapse early on so that appropriate interventions can be applied. Some common warning signs and behaviors to look out for might include negative thinking, poor self-care, increased conflict, feelings of fear and anxiety, neglecting spirituality, internalizing emotion, not asking for help or listening to suggestions, isolation, complacency, and self-destructive behaviors and attitudes.

Healthy responses and interventions for these warning signs include having an established routine, engaging in positive affirmations and thought stopping techniques, utilizing conflict resolution skills and assertive communication, recognizing irrational fears, applying anxiety management techniques, having a daily spiritual routine, practicing healthy expression of wants and needs, reflecting on behaviors, taking suggestions, attending meetings and remaining involved in treatment, raising awareness of motives, and having positive rewards for successes throughout the recovery process. 

Most addicts and alcoholics in recovery will find themselves somewhere in the relapse phase process at some point in their recovery. It is important to be aware of the phases, warning signs, and common symptoms of relapse so that the individual can intervene before relapse occurs. Intervention and redirection are possible with support, awareness, and skills training. Relapse prevention planning and related therapies can help the dependent individual to recognize his or her unique relapse warning signs so that he or she can create a comprehensive plan to address each phase and related behavior. Having this knowledge and proper coping skills can empower addicts, alcoholics, and loved ones as they continue on their path toward recovery.


Marie Tueller, MEd, LPC

Thursday, April 12, 2018

A Successful Recovering Addict

Success addiction recovery
Long-term sobriety is an extremely challenging thing to accomplish and maintain. Many addicts can maintain initial recovery and even stay abstinent for several months or years but ultimately relapse into old behaviors and drug use. For an addict, returning to the use of drugs is a maladaptive form of emotional coping. For a long time drugs were this individual’s solution to the pain and stress of life. It takes time and consistency to create new habits and ways of approaching the world around us. For addicts developing community and being rigorously honest in relationships is also crucial to maintaining these new rituals. A foundation in 12-step programs along with creating a new and exciting life are also factors that impact ones capability of maintaining long term sustainable recovery.

For many people taking the first step into recovery can feel like an impossible challenge. Vulnerability and open communication are not things that come naturally to someone who has been lying, and manipulating in order to get their needs met, because of this people often feel alone and lost. A helpful tool in taking that first step is attending drug and alcohol treatment. In rehabilitation facilities there is structured support and community to help the individual comfortably re-integrate into interpersonal relationships. Emotional pain and past trauma is often presents a high risk for relapse when not dealt with, in rehabilitation centers clients are offered therapy and support from licensed professionals to help them attain emotional regulation and healthy coping skills. Research shows that long-term treatment and after care have the highest success rates for maintaining sobriety. 

Creating a strong foundation in 12-step based programs is also integral to continuous and fulfilling recovery. Developing deep and committed relationships with other recovering addicts allows individuals to create community and support for themselves, which is crucial in moments of self-doubt and weakness. Addiction is a disease of silence and shame, so when people allow themselves to be vulnerable and continue to work on healthy honest communication their chances of remaining abstinent are vastly greater than when isolating. Lastly one of the most impactful ways to effect meaningful and consistent change, is for the addicts to create a new life for themselves, that they fill with creativity, relationships, hobbies and passion. A life that they love living.

Rebecca Kaplan-Rahimzadeh

Thursday, April 5, 2018

Enabling: Helping or Hurting?

Recognizing addiction in a loved one is often a painful experience frequently leaving the loved one and/or family members feeling lost and helpless. Many will turn to denial and attempt to rationalize the addict’s behavior while others will try to control and change the behavior. While these attempts to cope and “help” the addict typically stem from a genuine desire to support him or her and relieve distress, they often create more chaos and harm within relationships and the family system.

This is a common scenario in family systems and in relationships where one or more person suffers from a substance use disorder. Loved ones believe that they are helping when in fact they are enabling the addiction and ultimately causing the problem to become worse. How loved ones respond to the addict or alcoholic’s behavior is crucial in supporting their path to recovery.

Enabling can be defined as:

• Standing between a person and his or her consequences.
• Doing for someone something he or she should be doing for him or herself.
• Engaging in actions that ultimately perpetuate someone’s problematic behavior.

Families and loved ones often enable the addicts and alcoholics in their lives by:

• Getting stuck in the defenses
• Denying there is a problem
• Minimizing the problem
• Avoiding discussions about the problem
• Blaming others or lashing out with anger
• Joining in the rationalizations/justifications that their children create
• Taking over their responsibilities
• Continuing to provide financial support
• Helping to resolve legal problems
• Promising rewards for abstinence
• Suggesting a physical fitness program or a job change
• Threatening to kick them out
• Provoking arguments/nagging
• Avoiding getting help for themselves

In order to stop the cycle of enabling, it is important for not only the addict to receive help, but for families and loved ones to get their own support. Learning how to say no and set boundaries with someone who is active in an addiction is challenging and can often be frightening. Loved ones can benefit greatly from counseling, support groups, and coaching on how to practice self-care and set healthy boundaries with the addict in their lives.

Healthy functional boundaries create a system of limit setting that protects a person from being a victim and contains a person so that he/she is not offensive to others. They help to protect a person’s reality in relationships. They also allow for meaningful exchanges, healthy self-expression, and vulnerability. Addiction violates our boundary systems and requires loved ones to reestablish healthy boundaries in order to stop enabling behaviors that contribute to the chaos and harm that occurs within addicted family systems.

A healthy family with functional boundaries:

• Communicates honestly, directly and thoughtfully
• Supports and affirms one another
• Maintains trust through reliability and consistency
• Practices respect for each other and for others
• Shares a sense of order and responsibilities
• Shares leisure time and a positive sense of humor.
• Teaches traditions, values and right from wrong
• Shares attention among members in a balanced way
• Respects appropriate boundaries among each other
• Values service to others
• Is flexible under stress
• Resolves disagreements without damaging words
• As a system that is open to other people and new ideas
• Admits problems and seeks help from others
• Has a sense of optimism for the future

When working on establishing healthy functional boundaries in order to stop enabling behaviors within an alcoholic or addicted family system, it is almost always recommended that the entire family receive support and help while doing this work. Furthermore, it is important for family members to remember the “3 C’s” of addiction when breaking dysfunctional old patterns: “I didn't Cause it, I can't Cure it, and I can't Control it.” Family members and loved ones of alcoholics and addicts can practice these principles with support, coaching, and guidance. With help, it is possible to break the cycle of enabling and thereby create a foundation in recovery for the entire family unit.

Marie Tueller, MEd, LPC